Provider Demographics
NPI:1194361550
Name:MARQUEZ, ANNA VANESSA (PMHNP-BC, FNP-C)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:VANESSA
Last Name:MARQUEZ
Suffix:
Gender:
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 EUSTIS ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-2826
Mailing Address - Country:US
Mailing Address - Phone:617-445-1123
Mailing Address - Fax:617-830-9317
Practice Address - Street 1:245 EUSTIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-2826
Practice Address - Country:US
Practice Address - Phone:617-443-1123
Practice Address - Fax:617-830-9317
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2261167363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care