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NPI Code Detail

MEDICARE: LEANN CAROL MARQUEZ FNP

MEDICARE: LEANN CAROL MARQUEZ FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN.CNP.0028160OH
2363L00000XNurse PractitionerAPRN.CNP.0028160OH

General Provider Information

NPI Number : 1528655669
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANN CAROL MARQUEZ FNP
Provider Business Mailing Address
First Line : 803 ARMBRUSTER PKWY
Second Line :
City : WAVERLY
State : OH
Zip : 45690-3900
Country : US
Telephone Number : 740-947-6059
Fax Number :
Provider Business Practice Location Address
First Line : 2159 DOGWOOD RIDGE RD
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-9044
Country : US
Telephone Number : 731-394-1145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2020
Last Update Date : 03/11/2022

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