Provider Demographics
NPI:1922537018
Name:MARSHALL, KYEFE TAMEKA
Entity Type:Individual
Prefix:
First Name:KYEFE
Middle Name:TAMEKA
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 S JEFFERSON DAVIS PKWY STE 212
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1251
Mailing Address - Country:US
Mailing Address - Phone:504-821-7233
Mailing Address - Fax:504-304-2275
Practice Address - Street 1:3340 SEVERN AVE STE 320
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7410
Practice Address - Country:US
Practice Address - Phone:504-456-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210266251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care