Provider Demographics
NPI:1699043554
Name:MARSHALL, LARA ASHLEY (CNM)
Entity Type:Individual
Prefix:MRS
First Name:LARA
Middle Name:ASHLEY
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 N BEALE RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-6937
Mailing Address - Country:US
Mailing Address - Phone:530-645-7336
Mailing Address - Fax:530-743-9823
Practice Address - Street 1:1908 N BEALE RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-6937
Practice Address - Country:US
Practice Address - Phone:530-645-7336
Practice Address - Fax:530-743-9823
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC489367A00000X
CA236282367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife