Provider Demographics
NPI:1952832172
Name:MARQUEZ, ALEXIS NARLENE (BS PHARMACY)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:NARLENE
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 E OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-3446
Mailing Address - Country:US
Mailing Address - Phone:313-369-3977
Mailing Address - Fax:313-369-3943
Practice Address - Street 1:4909 E OUTER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3446
Practice Address - Country:US
Practice Address - Phone:313-369-3977
Practice Address - Fax:313-369-3943
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist