Provider Demographics
NPI:1437815016
Name:MARTZ, ANTOINETTE KATHLEEN (ARNP)
Entity type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:KATHLEEN
Last Name:MARTZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-6600
Mailing Address - Country:US
Mailing Address - Phone:515-570-8569
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 634
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:IA
Practice Address - Zip Code:50530-0634
Practice Address - Country:US
Practice Address - Phone:515-570-8569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2024-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA166068363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA166068OtherNURSE PRACTITIONER NUMBER