Individual
JESSICA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1601 MEDICAL ARTS BLVD, SUITE 201, ANDERSON, IN 46011-3458
(765) 298-5280
(765) 298-5279
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004639A
IN
364SA2200X
Adult Health Clinical Nurse Specialist
71004639A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201191150
—
IN
01
—
P01456903
RR MEDICARE
IN
Enumeration date
09/19/2013
Last updated
06/03/2022
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