Provider Demographics
NPI:1083256416
Name:MARQUARDT, STELLA (NP)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:MARQUARDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 RED MORGANITE TRL
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2204
Mailing Address - Country:US
Mailing Address - Phone:602-463-9766
Mailing Address - Fax:
Practice Address - Street 1:1823 FORTVIEW RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7672
Practice Address - Country:US
Practice Address - Phone:512-912-7707
Practice Address - Fax:512-912-9570
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2019050908363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care