Provider Demographics
NPI:1215319769
Name:MARSHALL, MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD STE K7
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8600
Mailing Address - Country:US
Mailing Address - Phone:512-454-5716
Mailing Address - Fax:512-454-6276
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE K7
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8600
Practice Address - Country:US
Practice Address - Phone:512-454-5716
Practice Address - Fax:512-454-6276
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2023-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX735583163W00000X
TXAP136502363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse