Provider Demographics
NPI:1710573407
Name:MARQUARDT, DAYNA ELIZABETH
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:ELIZABETH
Last Name:MARQUARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 CLARENDON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-2741
Mailing Address - Country:US
Mailing Address - Phone:313-772-3095
Mailing Address - Fax:
Practice Address - Street 1:919 CLARENDON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-2741
Practice Address - Country:US
Practice Address - Phone:313-772-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUH796277376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker