Individual
COURTNEY MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4495
(505) 842-8171
Mailing address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4495
(505) 842-8171
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA2019-0049
NM
363AM0700X
Medical Physician Assistant
Primary
PA9566
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49037544
—
NM
Enumeration date
07/05/2019
Last updated
09/19/2023
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