| Doctor Name: | TAMMI JO MARTINEZ |
| NPI Number: | 1376977488 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 2013021889 |
| Business Practice Address: | 907 E Reed St Hayti, MO - 638511242 |
| Business Phone Number: | 5733593660 |
| Business Fax Number: | |
| Mailing Address: | 609 Holly Hill Dr, SIKESTON |
| State: | MO |
| Postal Code: | 638013239 |
| Phone Number: | 5734758022 |
| Fax Number: | 5736952750 |
| NPI Enumeration Date: | 08/26/2013 |
| NPI Last Update Date: | 08/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2013021889 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |