Individual
KIM MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN RN CRNP FNP-C
Contact information
Practice address
252 OLD BRICK RD, HILLIARDS, PA 16040-1920
(724) 570-4565
Mailing address
252 OLD BRICK RD, HILLIARDS, PA 16040-1920
(724) 570-4565
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP016252
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN537399
PA STATE BOARD OF NURSING CERTIFICATION - RN
PA
01
—
SP016252
PA STATE BOARD OF NURSING CERTIFICATION - CRNP
PA
Enumeration date
06/24/2016
Last updated
08/16/2023
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