Provider Demographics
NPI:1619785904
Name:ATHAYDE PRICE, FERNANDA MARTINEZ
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:MARTINEZ
Last Name:ATHAYDE PRICE
Suffix:
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:PO BOX 1064
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-1064
Mailing Address - Country:US
Mailing Address - Phone:508-360-1347
Mailing Address - Fax:
Practice Address - Street 1:30 BENEFIT STREET
Practice Address - Street 2:APT 203
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649
Practice Address - Country:US
Practice Address - Phone:508-360-1347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula