Healthcare Provider Details

I. General information

NPI: 1649297250
Provider Name (Legal Business Name): MARIAJOY MARQUEZ REHMAN BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAJOY MARQUEZ R.N.

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

IV. Provider business mailing address

407 WINDSONG WAY
WOODSTOCK GA
30188-3791
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN137568
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: