Provider Demographics
NPI:1689096166
Name:MARQUIS, CHASIDY (FNP)
Entity Type:Individual
Prefix:
First Name:CHASIDY
Middle Name:
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 21ST ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1229
Mailing Address - Country:US
Mailing Address - Phone:806-761-7193
Mailing Address - Fax:802-796-3400
Practice Address - Street 1:3601 21ST ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1229
Practice Address - Country:US
Practice Address - Phone:806-761-7193
Practice Address - Fax:802-796-3400
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX674916363LF0000X
TXAP125153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily