Provider Demographics
NPI:1558765297
Name:MARSHALL, ANNE BRIDGET
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:BRIDGET
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANNE
Other - Middle Name:BRIDGET
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1026 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:13026-9753
Mailing Address - Country:US
Mailing Address - Phone:315-283-1228
Mailing Address - Fax:
Practice Address - Street 1:1026 CARPENTER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NY
Practice Address - Zip Code:13026-9753
Practice Address - Country:US
Practice Address - Phone:315-283-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY588795-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse