Provider Demographics
NPI:1982036331
Name:MARSHALL, MEIKE NADINE (PT)
Entity Type:Individual
Prefix:
First Name:MEIKE
Middle Name:NADINE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 WALKER LN STE 404
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3250
Mailing Address - Country:US
Mailing Address - Phone:703-797-6900
Mailing Address - Fax:703-797-6905
Practice Address - Street 1:6355 WALKER LN STE 404
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310
Practice Address - Country:US
Practice Address - Phone:703-797-6900
Practice Address - Fax:703-797-6905
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305-208113225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic