Provider Demographics
NPI:1669440731
Name:MARQUIS, MARY E (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 VISTA WAY
Mailing Address - Street 2:#206 HEALTHLINK MEDICAL CENTER
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056
Mailing Address - Country:US
Mailing Address - Phone:760-721-4000
Mailing Address - Fax:760-721-4005
Practice Address - Street 1:3142 VISTA WAY
Practice Address - Street 2:#206 HEALTHLINK MEDICAL CENTER
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056
Practice Address - Country:US
Practice Address - Phone:760-721-4000
Practice Address - Fax:760-721-4005
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1823482363L00000X
CA18267363LA2200X
CA311650363LA2200X
FL1823482363LA2200X
FL0102117363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651003929OtherTAX ID
FLE0132YMedicare PIN