Provider Demographics
NPI:1265935407
Name:MARQUEZ, JONATHAN MARC (RN)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:MARC
Last Name:MARQUEZ
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 1:13007 ADAMS CT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2115
Mailing Address - Country:US
Mailing Address - Phone:720-313-9663
Mailing Address - Fax:
Practice Address - Street 1:13007 ADAMS CT
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2115
Practice Address - Country:US
Practice Address - Phone:720-313-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN0182445163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse