Provider Demographics
NPI:1932878766
Name:MARSHALL, QUANISHA ANGELIQUE (ATS)
Entity Type:Individual
Prefix:MISS
First Name:QUANISHA
Middle Name:ANGELIQUE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 CRESTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2724
Mailing Address - Country:US
Mailing Address - Phone:615-295-1236
Mailing Address - Fax:
Practice Address - Street 1:1301 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37132-2724
Practice Address - Country:US
Practice Address - Phone:615-295-1236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program