Provider Demographics
NPI:1942051792
Name:MARSH, RENEATHIA E
Entity Type:Individual
Prefix:
First Name:RENEATHIA
Middle Name:E
Last Name:MARSH
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 1:621 KIRTS BLVD APT 102
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4119
Mailing Address - Country:US
Mailing Address - Phone:248-392-7550
Mailing Address - Fax:
Practice Address - Street 1:621 KIRTS BLVD APT 102
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4119
Practice Address - Country:US
Practice Address - Phone:248-392-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide