Provider Demographics
NPI:1164190575
Name:RONEY, MARQUEZ J (RN)
Entity Type:Individual
Prefix:
First Name:MARQUEZ
Middle Name:J
Last Name:RONEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3460
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-3460
Mailing Address - Country:US
Mailing Address - Phone:229-310-7251
Mailing Address - Fax:
Practice Address - Street 1:5053 GREYFIELD PL N
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-7087
Practice Address - Country:US
Practice Address - Phone:229-310-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN259293163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty