Basic Information
| Provider Information | |||||||||
| NPI: | 1639315831 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARSHALL | ||||||||
| FirstName: | DEBBIE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PHMNP- BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 741 SCHOLL RD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449071571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197561717 | ||||||||
| FaxNumber: | 4197745955 | ||||||||
| Practice Location | |||||||||
| Address1: | 741 SCHOLL RD | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449071571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197561717 | ||||||||
| FaxNumber: | 4197745955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2008 | ||||||||
| LastUpdateDate: | 04/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | COA.10467-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.