Individual
AMANDA RAE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7453
(423) 844-1121
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
203805
TN
363L00000X
Nurse Practitioner
28250
TN
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
28250
TN
Other
Enumeration date
08/23/2020
Last updated
07/14/2021
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