Provider Demographics
NPI:1477143865
Name:MARQUEZ, ROBIN ANNE (FNP-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANNE
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 AIRFIELD CT
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-8001
Mailing Address - Country:US
Mailing Address - Phone:928-530-4639
Mailing Address - Fax:
Practice Address - Street 1:2607 AIRFIELD CT
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-8001
Practice Address - Country:US
Practice Address - Phone:928-530-4639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP252686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily