Provider Demographics
NPI:1669722070
Name:MARQUEZ, LAURA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CURIE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2905
Mailing Address - Country:US
Mailing Address - Phone:915-356-3939
Mailing Address - Fax:915-351-7201
Practice Address - Street 1:1250 E CLIFF DR STE 1C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-351-7200
Practice Address - Fax:915-351-7201
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX785708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1831267079OtherGROUP NPI
451901OtherMEDICARE A GROUP #
00B14GOtherMEDICARE B GROUP #
TX130880104OtherGROUP TPI