Provider Demographics
NPI:1417415183
Name:EKREN, MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:EKREN
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42068 N RATTLESNAKE RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-8858
Mailing Address - Country:US
Mailing Address - Phone:602-345-0348
Mailing Address - Fax:602-848-8890
Practice Address - Street 1:21139 S 187TH WAY
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-3584
Practice Address - Country:US
Practice Address - Phone:602-345-0348
Practice Address - Fax:602-848-8890
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN138316363LF0000X
AZRNP246860363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily