Provider Demographics
NPI:1730882531
Name:MARTINEZ, VICTORIA LILYANNA (APRN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LILYANNA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1242
Mailing Address - Country:US
Mailing Address - Phone:620-663-8484
Mailing Address - Fax:620-663-9526
Practice Address - Street 1:2700 E 30TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1242
Practice Address - Country:US
Practice Address - Phone:620-663-8484
Practice Address - Fax:620-663-9526
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5382047082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily