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General NPI Number Information
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NPI Number | 1619793973
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Entity Type | Individual
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Provider Name | MARQUITA HAHN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 400 BENEDICTA AVE
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City | TRINIDAD
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State | CO
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Zip | 81082-2099
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Country | US
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Telephone | 719-846-2206
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | WESTON
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State | CO
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Zip | 81091-0160
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Country | US
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Telephone | 910-273-4411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.1000330-NP
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License Number State | CO
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