Individual
MS. LAUREN NICOLE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 257-5455
(618) 257-4490
Mailing address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 257-5455
(618) 257-4490
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019005033
MO
363LF0000X
Family Nurse Practitioner
041427324
IL
363LF0000X
Family Nurse Practitioner
2019005033
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401027711
—
IL
05
—
420075085
—
MO
Enumeration date
02/23/2019
Last updated
12/06/2024
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