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Individual

ANGELA CHRISTINE MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
20 MEDICAL VILLAGE DR, STE 258, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
367500000X
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000014440-00
BUREAU OF WORKERS COMPENSATION
05
7100292760
KY
Enumeration date
01/08/2014
Last updated
07/22/2014
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