Provider Demographics
NPI:1851727259
Name:MARSHALL, SANDRA FITZGERALD (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:FITZGERALD
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 MEDICAL CENTER DR SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3421
Mailing Address - Country:US
Mailing Address - Phone:256-844-8144
Mailing Address - Fax:256-844-8177
Practice Address - Street 1:423 MEDICAL CENTER DR SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3421
Practice Address - Country:US
Practice Address - Phone:256-844-8144
Practice Address - Fax:256-844-8177
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-107901364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health