Provider Demographics
NPI:1811965189
Name:MARSHALL, ALFREDA RENNAE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ALFREDA
Middle Name:RENNAE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:530 ZEAGLER DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-6855
Mailing Address - Country:US
Mailing Address - Phone:386-325-0826
Mailing Address - Fax:386-325-6419
Practice Address - Street 1:530 ZEAGLER DR
Practice Address - Street 2:SUITE #2
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-6855
Practice Address - Country:US
Practice Address - Phone:386-325-0826
Practice Address - Fax:386-325-6419
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP3212052363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology