Individual
KILEY MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PNP-PC
Contact information
Practice address
2715 OSLER DR, GRAND PRAIRIE, TX 75051-1051
(972) 206-2940
Mailing address
300 TRAILHOUSE LN APT 1113, FORNEY, TX 75126-3158
(903) 603-6031
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1004526
TX
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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