Individual
PENNIE KATHALEEN MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9441 CREEK VIEW DR, FARWELL, MI 48622-8452
(989) 588-0301
Mailing address
9441 CREEK VIEW DRIVE, FARWELL, MI 48622
(989) 588-0301
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703099359
MI
Other
Enumeration date
01/27/2009
Last updated
01/27/2009
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