Individual
DR. MARISSA MANIPUD MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP, RN
Contact information
Practice address
224 W.D. L INGRAM AVENUE, BLDG 1408, CANNON AFB, NM 88103
(575) 784-2778
Mailing address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W.D. L INGRAM AVENUE, BLDG 1408, CANNON AFB, NM 88103
(575) 784-4037
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NP95008125
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95008125
CA
Other
Enumeration date
12/20/2017
Last updated
04/22/2025
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