Provider Demographics
NPI:1083362826
Name:MARSHALL, JANE (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E WINONA AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19074-1318
Mailing Address - Country:US
Mailing Address - Phone:610-731-9892
Mailing Address - Fax:
Practice Address - Street 1:50 APPLIED BANK BLVD
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1091
Practice Address - Country:US
Practice Address - Phone:484-844-1464
Practice Address - Fax:800-355-1029
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered