Healthcare Provider Details

I. General information

NPI: 1669362497
Provider Name (Legal Business Name): MS. ANA LESLY MARQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 COLUMBINE ST
STERLING CO
80751-3728
US

IV. Provider business mailing address

213 W 6TH AVE
FORT MORGAN CO
80701-2002
US

V. Phone/Fax

Practice location:
  • Phone: 970-522-3741
  • Fax: 970-522-1412
Mailing address:
  • Phone: 970-554-1453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License NumberRN.1692733
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: