Individual
GABRIEL MENDOZA MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
315 HOSPITAL DR, MADISON, TN 37115-5030
(617) 732-7662
Mailing address
315 HOSPITAL DR, MADISON, TN 37115-5030
(617) 732-7662
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1097780
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
1097780
TX
Other
Enumeration date
10/31/2022
Last updated
12/24/2024
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