Individual
CRYSTAL ROSE MARQUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2300 E 30TH ST STE C2, FARMINGTON, NM 87401-8991
(505) 324-1000
Mailing address
3902 HOLIDAY DR, FARMINGTON, NM 87402-4632
(505) 402-6182
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA2021-0119
NM
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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