Provider Demographics
NPI:1851406011
Name:MARSHALL, LINDSEY ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ELIZABETH
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:#8894
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9001
Mailing Address - Country:US
Mailing Address - Phone:619-543-2542
Mailing Address - Fax:619-543-2540
Practice Address - Street 1:2200 PARK AVE. BLDG. D STE. 100
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060
Practice Address - Country:US
Practice Address - Phone:435-615-8822
Practice Address - Fax:435-615-8823
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20419363AS0400X
NC0010-00485363A00000X
CO2516363AS0400X
UT8599800-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical