Provider Demographics
NPI:1942457452
Name:MARSHALL-WILLIAMS, LORRAINE (FNP)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:
Last Name:MARSHALL-WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2308 30TH AVE
Mailing Address - Street 2:NONE
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3494
Mailing Address - Country:US
Mailing Address - Phone:424-256-6274
Mailing Address - Fax:
Practice Address - Street 1:2308 30TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3494
Practice Address - Country:US
Practice Address - Phone:424-256-6274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243406163W00000X
NY336111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse