Provider Demographics
NPI:1396395224
Name:MARSHALL, ANN MARIE (WHNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12600 JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8665
Mailing Address - Country:US
Mailing Address - Phone:612-380-8161
Mailing Address - Fax:
Practice Address - Street 1:918 W LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2857
Practice Address - Country:US
Practice Address - Phone:612-823-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6915363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health