| Denise Joan Martin, FNP-C | |
|
405 W 4th St, Portales, NM 88130-6364 | |
| (575) 226-3898 | |
| (575) 226-3890 |
| Full Name | Denise Joan Martin |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 405 W 4th St, Portales, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548568512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | CNP-01717 (New Mexico) | Primary |
| Entity Name | Sunnylane Medical Clinic LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255922811 PECOS PAC ID: 0042608820 Enrollment ID: O20211027002677 |
| Mailing Address | Practice Location Address |
|---|---|
| Denise Joan Martin, FNP-C 405 W 4th St, Portales, NM 88130-6364 Ph: (575) 226-3898 | Denise Joan Martin, FNP-C 405 W 4th St, Portales, NM 88130-6364 Ph: (575) 226-3898 |
Mrs. Shanna Lee Campbell, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 42121 Us Highway 70, Portales, NM 88130 Phone: 575-356-6652 |
Lindsay Young, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 42121 Us Highway 70, Portales, NM 88130 Phone: 575-356-6652 Fax: 575-359-6827 |
Teresa Claire Evan, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1515 W Fir St, Portales, NM 88130 Phone: 575-356-6695 Fax: 575-356-5948 |
Kerri Renee Self, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 405 W 4th St, Portales, NM 88130 Phone: 575-226-3898 Fax: 575-226-3890 |
Eva F Toelle, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 42121 Us Hwy 70, Portales, NM 88130 Phone: 575-356-6652 Fax: 575-359-6827 |
Sylvia Anne Rife, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 42121 Us Hwy 70, Portales, NM 88130 Phone: 575-356-6652 Fax: 575-226-0099 |
Mrs. Johanna Christine Pettrey, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1515 W Fir St, Portales, NM 88130 Phone: 575-356-6695 |