Individual
MS. KATHLEEN BRIDGET MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
717 MISSION RD., FORT HALL, ID 83203-0717
(208) 238-5435
Mailing address
9530 W HEATHER RD, POCATELLO, ID 83204-7232
(208) 233-7699
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
NP433A
ID
363LW0102X
Women's Health Nurse Practitioner
Primary
NP433A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8063500
—
ID
05
—
8064977
—
ID
05
—
80662922
—
ID
Enumeration date
05/17/2007
Last updated
09/11/2025
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