Provider Demographics
NPI:1831580414
Name:MARQUETTE, LORRAINE (RN)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:MARQUETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 TOWERSIDE CT
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3926
Mailing Address - Country:US
Mailing Address - Phone:262-424-3654
Mailing Address - Fax:
Practice Address - Street 1:1040 TOWERSIDE CT
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3926
Practice Address - Country:US
Practice Address - Phone:262-424-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI88521163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn