Provider Demographics
NPI:1811980642
Name:SOUERS, MARSHA (NP)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:SOUERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:14 CALLE LAGARTIJAS
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-9504
Mailing Address - Country:US
Mailing Address - Phone:505-771-8071
Mailing Address - Fax:505-771-8071
Practice Address - Street 1:5608 ZUNI RD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108
Practice Address - Country:US
Practice Address - Phone:505-262-2481
Practice Address - Fax:505-265-7045
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2019-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMR54597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ15434Medicare UPIN