Provider Demographics
NPI:1255486437
Name:MARSHALL, KRISTINA DAWN (LVN)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:DAWN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 4TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-2433
Mailing Address - Country:US
Mailing Address - Phone:661-765-7025
Mailing Address - Fax:661-765-7045
Practice Address - Street 1:1021 4TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2433
Practice Address - Country:US
Practice Address - Phone:661-765-7025
Practice Address - Fax:661-765-7045
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN218627164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse