Provider Demographics
NPI:1720298193
Name:MARSHALL, DORIS L (NURSE AIDE)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:L
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6440
Mailing Address - Street 2:25 ARCHIE ROAD
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77342-6440
Mailing Address - Country:US
Mailing Address - Phone:936-581-2553
Mailing Address - Fax:
Practice Address - Street 1:21 ARCHIE RD
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77320
Practice Address - Country:US
Practice Address - Phone:936-581-2553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCERTIFIED NURSE AIDE311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home