Provider Demographics
NPI:1942406186
Name:MARSH, MARSHA A (RN)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:A
Last Name:MARSH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 SHALE DR
Mailing Address - Street 2:APT. C
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-8299
Mailing Address - Country:US
Mailing Address - Phone:740-453-9548
Mailing Address - Fax:
Practice Address - Street 1:3010 SHALE DR
Practice Address - Street 2:APT.C
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-8299
Practice Address - Country:US
Practice Address - Phone:740-453-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 234239163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH259-3582Medicaid