Provider Demographics
NPI:1487103735
Name:FUNCHES, MARTINA
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:
Last Name:FUNCHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 LAKE FOREST BLVD STE 607
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-6201
Mailing Address - Country:US
Mailing Address - Phone:504-265-1230
Mailing Address - Fax:504-371-5937
Practice Address - Street 1:10001 LAKE FOREST BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-6200
Practice Address - Country:US
Practice Address - Phone:504-323-3440
Practice Address - Fax:866-294-2148
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator