Provider Demographics
NPI:1528655669
Name:MARQUEZ, LEANN CAROL (FNP)
Entity type:Individual
Prefix:
First Name:LEANN
Middle Name:CAROL
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LEANN
Other - Middle Name:CAROL
Other - Last Name:HORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:803 ARMBRUSTER PKWY
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-3900
Mailing Address - Country:US
Mailing Address - Phone:740-947-6059
Mailing Address - Fax:
Practice Address - Street 1:2159 DOGWOOD RIDGE RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-9044
Practice Address - Country:US
Practice Address - Phone:731-394-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028160363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily