Provider Information for 1124757018
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ANITA L MARSHALL
Sex: Female
NPI: 1124757018
Last Updated: 2024-07-22
Certification Date: 2024-07-22
Certification Date: 2024-07-22
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124757018 | ||||||||||||
| Enumeration Date | 2022-06-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 10466 MEADOWVIEW DR KEITHVILLE, LA 71047-9562 United States Phone: 318-453-1177 | Fax: | ||||||||||||
| Primary Practice Address | 6009 FINANCIAL PLZ STE 102 SHREVEPORT, LA 71129-2615 United States Phone: 318-828-1455 | Fax: | ||||||||||||
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