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Individual

JASON KELLY MARQUART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ACNP-BC

Contact information

Practice address
3851 ROGER BROOKE DRIVE, MCHE-QD (CREDS), FORT SAM HOUSTON, TX 78234-6200
(210) 916-3390
Mailing address
BAMC-3851 ROGER BROOKE DRIVE, MCHE-QD (CREDS), FORT SAM HOUSTON, TX 78234-6200
(210) 916-3390

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
810728
TX

Other

Enumeration date
02/03/2012
Last updated
02/03/2012
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