Provider Demographics
NPI:1215265475
Name:MARQUEZ, JAMIE N (CNA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:N
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 LAGUNITAS RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-7577
Mailing Address - Country:US
Mailing Address - Phone:505-615-6011
Mailing Address - Fax:
Practice Address - Street 1:221 LAGUNITAS RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-7577
Practice Address - Country:US
Practice Address - Phone:505-615-6011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM0068740109E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide