Provider Demographics
NPI:1710958491
Name:MARQUART, CHERYL ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:MARQUART
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3041
Mailing Address - Country:US
Mailing Address - Phone:503-871-0412
Mailing Address - Fax:
Practice Address - Street 1:920 COUNTRY CLUB RD STE 220B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6090
Practice Address - Country:US
Practice Address - Phone:541-342-5012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR099007712CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered