Provider Demographics
NPI:1366575284
Name:MARQUIS, ROSANNE S (NP)
Entity type:Individual
Prefix:MRS
First Name:ROSANNE
Middle Name:S
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ROSANNE
Other - Middle Name:S
Other - Last Name:CRIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:324 GANNETT DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-783-2300
Mailing Address - Fax:207-783-2439
Practice Address - Street 1:77 BATES STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-783-2300
Practice Address - Fax:207-783-2439
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER022162363L00000X
MECNP81800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner