Individual
MR. BENJAMIN OWEN MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-BC, CPHQ
Contact information
Practice address
3500 COOLIDGE RD, EAST LANSING, MI 48823-6376
(517) 940-7615
Mailing address
10500 B DR N, CERESCO, MI 49033-9633
(517) 897-3705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704371368
MI
363LF0000X
Family Nurse Practitioner
Primary
4704371368
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704371368
REGISTERED NURSE LICENSE
MI
Enumeration date
02/03/2023
Last updated
08/25/2024
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