Provider Demographics
NPI:1689329674
Name:MARCHANT, JASON (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MARCHANT
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5725
Mailing Address - Country:US
Mailing Address - Phone:954-224-9553
Mailing Address - Fax:
Practice Address - Street 1:4902 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-5725
Practice Address - Country:US
Practice Address - Phone:954-224-9553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily