| Doctor Name: | MS. MARTHA MAURA ANDERSON |
| NPI Number: | 1326456195 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | CNP-02470 |
| Business Practice Address: | 1950 N Date St Truth Or Consequences, NM - 879013701 |
| Business Phone Number: | 5758948057 |
| Business Fax Number: | |
| Mailing Address: | 1950 N Date St, TRUTH OR CONSEQUENCES |
| State: | NM |
| Postal Code: | 879013701 |
| Phone Number: | 5758948057 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2014 |
| NPI Last Update Date: | 07/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP-02470 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |