Provider Demographics
NPI:1437752888
Name:MARQUART, KARA S (PAC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:S
Last Name:MARQUART
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:S
Other - Last Name:BEDNAREK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:34700 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4500
Mailing Address - Country:US
Mailing Address - Phone:262-646-4411
Mailing Address - Fax:262-646-3158
Practice Address - Street 1:34700 VALLEY RD
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4500
Practice Address - Country:US
Practice Address - Phone:262-646-4411
Practice Address - Fax:262-646-3158
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5267363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant