Provider Demographics
NPI:1497450852
Name:WALSH, MARISSA (MD)
Entity type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY ROAD
Mailing Address - Street 2:SUITE 202, CU DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-280-4438
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY ROAD
Practice Address - Street 2:SUITE 202, CU DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-280-4438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9944207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology