Individual
MARY THERESE MEYERS-MARQUARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC, ANP
Contact information
Practice address
402 W COUNTRY CLUB RD, ROSWELL, NM 88201-5247
(575) 637-7000
(575) 637-7019
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
256947
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
CNP-02624
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200646201
—
TX
01
—
519408YYH0
MEDICARE
NM
01
—
8Y5552
TEXAS BCBS
TX
Enumeration date
05/06/2006
Last updated
03/17/2018
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