Provider Demographics
NPI:1639936024
Name:MARSHALL, KHANDICE (CD(DONA), CCCE)
Entity type:Individual
Prefix:MRS
First Name:KHANDICE
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:CD(DONA), CCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 CAMP AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-4803
Mailing Address - Country:US
Mailing Address - Phone:908-380-0071
Mailing Address - Fax:
Practice Address - Street 1:151 CAMP AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-4803
Practice Address - Country:US
Practice Address - Phone:908-380-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula