Individual
AMI S MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
530 MIDDLEBURY RD STE 103A, MIDDLEBURY, CT 06762-2547
(203) 527-6953
(203) 528-4331
Mailing address
530 MIDDLEBURY RD STE 103A, MIDDLEBURY, CT 06762-2547
(203) 527-6953
(203) 528-4331
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
003111
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004247872
—
CT
01
—
500001891
MEDICARE
—
Enumeration date
08/09/2006
Last updated
04/24/2024
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