Provider Demographics
NPI:1811187594
Name:MARSHALL, VALERIANN BIZON (NP-C)
Entity Type:Individual
Prefix:MS
First Name:VALERIANN
Middle Name:BIZON
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 SUN VALLEY DR
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5612
Mailing Address - Country:US
Mailing Address - Phone:678-990-5401
Mailing Address - Fax:678-990-5405
Practice Address - Street 1:555 SUN VALLEY DR
Practice Address - Street 2:SUITE D-1
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5612
Practice Address - Country:US
Practice Address - Phone:678-990-5401
Practice Address - Fax:678-990-5405
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN054505 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily