Provider Demographics
NPI:1023176757
Name:MARQUART, ANDREW LEE I (PLMHP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEE
Last Name:MARQUART
Suffix:I
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 HILL DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3940 CORNHUSKER HWY
Practice Address - Street 2:STE 600
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-1534
Practice Address - Country:US
Practice Address - Phone:402-464-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8171101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health