Individual
KELLY L MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
300 N LEE BLVD, PRESCOTT, AZ 86301-5710
(928) 708-4300
(928) 458-2122
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
219517
AZ
363LF0000X
Family Nurse Practitioner
F101814346
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
466479
—
AZ
Enumeration date
11/05/2018
Last updated
02/10/2025
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