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Individual

DAMALI MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3905 DUE WEST RD NW, MARIETTA, GA 30064-1019
(678) 290-5740
Mailing address
3905 DUE WEST RD NW, MARIETTA, GA 30064-1019
(678) 290-5740

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
160719 NP
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202I506510
PTAN
GA
Enumeration date
03/29/2011
Last updated
11/04/2021
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