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Individual
MARCO ANTONIO PENA
Active
Individual
MARCO ANTONIO PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1072107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072107
APRN-CNP
TX
Enumeration date
04/05/2022
Last updated
04/05/2022
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