Provider Demographics
NPI:1831614155
Name:MARQUEZ, ERICA MARIE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MARIE
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:MARIE
Other - Last Name:URBINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:501 STAGECOACH RD
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-6738
Mailing Address - Country:US
Mailing Address - Phone:505-409-4630
Mailing Address - Fax:
Practice Address - Street 1:516 E NIZHONI BLVD
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5748
Practice Address - Country:US
Practice Address - Phone:505-722-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-75049163WX0003X
NMF03230749363LF0000X
NM73389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient