Martz, Wallis H

Martz, Wallis H is an individual health care provider with primary practice located at 2339 Mccallie Ave Suite 309, Chattanooga TN 37404-3256. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Martz, Wallis H can be contacted via phone (423) 698-0850.

Contact Information

Primary practice address
2339 Mccallie Ave Suite 309 Chattanooga TN 37404-3256
Fax: (423) 698-0511
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 50413 Tennessee

Profile Details

NPI number 1154320422
LBN Legal business name Martz, Wallis H
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Aug 17th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154320422 NPPES
Tennessee Other P00435620 RAILROAD MEDICARE
Tennessee Other 4156507 RAILROAD MEDICARE
Tennessee MEDICAID 33491821 RAILROAD MEDICARE

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