Provider Demographics
NPI:1700699329
Name:MARTYNENKO, NINA G (RN)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:G
Last Name:MARTYNENKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 N LEE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-4664
Mailing Address - Country:US
Mailing Address - Phone:509-473-4900
Mailing Address - Fax:
Practice Address - Street 1:22820 E APPLEWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-5214
Practice Address - Country:US
Practice Address - Phone:509-473-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00176324163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health