Martin, Fonshay Latrice
Martin, Fonshay Latrice is an individual health care provider with primary practice located at 113 Pleasant Valley Dr Ste 210 , Boerne TX 78006-5683. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Martin, Fonshay Latrice can be contacted via phone (830) 267-4575.Contact Information
Primary practice address
113 Pleasant Valley Dr Ste 210
Boerne TX 78006-5683
Phone: (830) 267-4575
Fax: (830) 267-4575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 860200 | Nevada |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | AP115919 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 705048 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 70334 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 5381716052 | Kansas |
Profile Details
| NPI number | 1588814263 |
|---|---|
| LBN Legal business name | Martin, Fonshay Latrice |
| Credentials | GNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2008 |
| Last updated | Aug 15th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588814263 | NPPES |
| Texas | MEDICAID | 206653214 |
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