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Individual

JUANISHA DE'SHA MARSHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3050 HELMSDALE PL APT 2107, LEXINGTON, KY 40509-2442
(859) 433-6418
Mailing address
3050 HELMSDALE PL APT 2107, LEXINGTON, KY 40509-2442
(859) 433-6418

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11442581
KY
363LF0000X
Family Nurse Practitioner
Primary
3015229
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3015229
APRN LICENSE
KY
Enumeration date
02/26/2020
Last updated
01/25/2021
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