Healthcare Provider Details

I. General information

NPI: 1669838751
Provider Name (Legal Business Name): CHRISTINE R MARQUARDT PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2016
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 N COURT ST STE 102
FREDERICK MD
21701-5461
US

IV. Provider business mailing address

3861 TRITON LN
FREDERICK MD
21704-7007
US

V. Phone/Fax

Practice location:
  • Phone: 240-253-1323
  • Fax: 240-253-1323
Mailing address:
  • Phone: 240-388-7420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number905830
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR130851
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: