Provider Demographics
NPI:1881278661
Name:MARSHALL, MAUREEN DONNETTE (NP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:DONNETTE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2337
Mailing Address - Country:US
Mailing Address - Phone:732-917-2900
Mailing Address - Fax:
Practice Address - Street 1:10 STERLING DR
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4911
Practice Address - Country:US
Practice Address - Phone:908-358-6828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2024-10-09
Deactivation Date:2024-09-29
Deactivation Code:
Reactivation Date:2024-10-09
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01171000363LG0600X
NJ26NO11768400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology