Provider Demographics
NPI:1689345043
Name:MARSHALL, KATHERINE ANN (DNP)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:30410 FOX CLUB DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1951
Mailing Address - Country:US
Mailing Address - Phone:248-231-1195
Mailing Address - Fax:
Practice Address - Street 1:30800 TELEGRAPH RD STE 1728
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-5703
Practice Address - Country:US
Practice Address - Phone:248-231-1195
Practice Address - Fax:248-967-8741
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704218872363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health