Provider Demographics
NPI:1417726241
Name:MARQUEZ, CELENDONIA MYRNA MENOR (FNP-C)
Entity Type:Individual
Prefix:
First Name:CELENDONIA MYRNA
Middle Name:MENOR
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CELENDONIA MYRNA
Other - Middle Name:DELA CRUZ
Other - Last Name:MENOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1190 W NORTHERN PKWY APT 407
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1453
Mailing Address - Country:US
Mailing Address - Phone:443-756-7759
Mailing Address - Fax:
Practice Address - Street 1:1190 W NORTHERN PKWY APT 407
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1453
Practice Address - Country:US
Practice Address - Phone:443-756-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR219010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily