Provider Demographics
NPI:1811441470
Name:MARSHALL, CHRISTY DAWN
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:DAWN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHRISTY
Other - Middle Name:DAWN
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHLEBOTOMIST
Mailing Address - Street 1:6269 S STATE ROAD 62
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47138-7408
Mailing Address - Country:US
Mailing Address - Phone:812-265-4877
Mailing Address - Fax:812-273-5950
Practice Address - Street 1:421 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3565
Practice Address - Country:US
Practice Address - Phone:812-265-4877
Practice Address - Fax:812-273-5950
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No374700000XNursing Service Related ProvidersTechnician