Provider Demographics
NPI:1952691099
Name:MARROQUIN, JOANNA MARIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MARIE
Last Name:MARROQUIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:MARIE
Other - Last Name:BENESTANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2 GREENWAY PLZ
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0297
Mailing Address - Country:US
Mailing Address - Phone:832-828-3660
Mailing Address - Fax:832-828-3660
Practice Address - Street 1:6701 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2608
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA607497163W00000X
TX733179163W00000X, 363LF0000X
PASP011332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX733179OtherTEXAS BOARD OF NURSING
PASP011332OtherCERTIFIED REGISTERED NURSE PRACTITIONER