Provider Demographics
NPI:1881029361
Name:MARSHALL, JILLIAN ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:ELIZABETH
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DAMANTE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5759
Mailing Address - Country:US
Mailing Address - Phone:603-228-2279
Mailing Address - Fax:603-228-9729
Practice Address - Street 1:20 DAMANTE DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5759
Practice Address - Country:US
Practice Address - Phone:603-228-2279
Practice Address - Fax:603-228-9729
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1783183500000X
MEPR5369183500000X
MAPH24102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist