Individual
STACI MARIE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
844 BOULEVARD ST, DOVER, OH 44622-2008
(330) 473-6615
(330) 441-4352
Mailing address
844 BOULEVARD ST, DOVER, OH 44622-2008
(330) 473-6615
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11931
OH
363L00000X
Nurse Practitioner
Primary
COA.11931-NP
OH
363LF0000X
Family Nurse Practitioner
COA.11931-NP
OH
Other
Enumeration date
01/04/2011
Last updated
12/19/2022
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