Provider Demographics
NPI:1154168086
Name:MARTI, CHARISE ALICIA (APRN)
Entity type:Individual
Prefix:
First Name:CHARISE
Middle Name:ALICIA
Last Name:MARTI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7131 W 135TH ST # 1093
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-1238
Mailing Address - Country:US
Mailing Address - Phone:913-800-0839
Mailing Address - Fax:949-810-5428
Practice Address - Street 1:7131 W 135TH ST # 1093
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1238
Practice Address - Country:US
Practice Address - Phone:913-800-0839
Practice Address - Fax:949-810-5428
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012023983163W00000X
KS14-116708-121163W00000X
KS53-83411-121363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse