Healthcare Provider Details

I. General information

NPI: 1811917545
Provider Name (Legal Business Name): DENISE M MARQUIS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HOULTON STREET
PATTEN ME
04765
US

IV. Provider business mailing address

164 LINCOLN ST
MILLINOCKET ME
04462-1224
US

V. Phone/Fax

Practice location:
  • Phone: 207-528-2285
  • Fax: 207-528-2880
Mailing address:
  • Phone: 207-723-6233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: