Provider Demographics
NPI:1689199721
Name:MARSHALL, JAMYLA JOANNE
Entity Type:Individual
Prefix:
First Name:JAMYLA
Middle Name:JOANNE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10319 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WHITE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32096-1941
Mailing Address - Country:US
Mailing Address - Phone:386-234-5259
Mailing Address - Fax:
Practice Address - Street 1:317 4TH ST NW
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:FL
Practice Address - Zip Code:32052-5953
Practice Address - Country:US
Practice Address - Phone:386-938-3286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion