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NPI Code Detail

MEDICARE: MARQUETTA RENEE NAVARRO FNP-BC

MEDICARE:   MARQUETTA RENEE NAVARRO  FNP-BC
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 Practitioner28203328AIN

General Provider Information

NPI Number : 1922610617
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARQUETTA RENEE NAVARRO FNP-BC
Provider Business Mailing Address
First Line : 6702 WOODCREST DR
Second Line :
City : AVON
State : IN
Zip : 46123-7568
Country : US
Telephone Number : 317-607-0982
Fax Number :
Provider Business Practice Location Address
First Line : 602 N HIGH SCHOOL RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46214-3694
Country : US
Telephone Number : 317-291-1211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2020
Last Update Date : 08/23/2020

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Directions to “ MARQUETTA RENEE NAVARRO FNP-BC” Practice Location

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