Provider Demographics
NPI:1477858835
Name:MARQUARDSEN, AARON MATTHEW
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MATTHEW
Last Name:MARQUARDSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 AGUA FRIA PARK RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-3424
Mailing Address - Country:US
Mailing Address - Phone:612-598-8258
Mailing Address - Fax:
Practice Address - Street 1:5001 AGUA FRIA PARK RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-3424
Practice Address - Country:US
Practice Address - Phone:612-598-8258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist