Provider Demographics
NPI:1437119807
Name:MARSHALL, NANCY J (FNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:J
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-283-7000
Mailing Address - Fax:207-282-9128
Practice Address - Street 1:272 COTTAGE STREET
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073
Practice Address - Country:US
Practice Address - Phone:207-490-7795
Practice Address - Fax:207-324-6275
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME264610099Medicaid
NP2848Medicare ID - Type Unspecified
ME264610099Medicaid