Provider Demographics
NPI:1871654996
Name:MARSHALL, MAURA (ARNP, MSN, CCRN)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:ARNP, MSN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2222
Mailing Address - Country:US
Mailing Address - Phone:603-926-0088
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6472
Practice Address - Fax:603-663-6645
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH034969-21163W00000X
NH034969-23-03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0711730Medicaid
NH30342305Medicaid
NH01Y002612NH04OtherANTHEM
P11834Medicare UPIN
NH30342305Medicaid