Provider Demographics
NPI:1417224403
Name:MARSHALL, ANITA D'AUBREY (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:D'AUBREY
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 KENT ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5858
Mailing Address - Country:US
Mailing Address - Phone:432-687-2273
Mailing Address - Fax:
Practice Address - Street 1:407 KENT ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5858
Practice Address - Country:US
Practice Address - Phone:432-687-2273
Practice Address - Fax:432-687-1016
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX705945364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health