Provider Demographics
NPI:1093507626
Name:MARTIN, SHEREE DANETTE X
Entity type:Individual
Prefix:PROF
First Name:SHEREE
Middle Name:DANETTE
Last Name:MARTIN
Suffix:X
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2889 TUPPENCE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5504
Mailing Address - Country:US
Mailing Address - Phone:614-207-6149
Mailing Address - Fax:614-207-6149
Practice Address - Street 1:2889 TUPPENCE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-5504
Practice Address - Country:US
Practice Address - Phone:614-207-6149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376G00000XNursing Service Related ProvidersNursing Home Administrator