Individual
MR. KEVIN JAMES MARSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
6602 E PHELPS RD, SCOTTSDALE, AZ 85254-5659
(207) 831-2002
Mailing address
13555 W MCDOWELL RD, STE 205, GOODYEAR, AZ 85395-2626
(207) 831-2002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
249498
AZ
363LA2100X
Acute Care Nurse Practitioner
Primary
249498
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720688443
—
AZ
Enumeration date
10/30/2020
Last updated
11/30/2021
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