Provider Demographics
NPI:1699075721
Name:MARSHALL, NATALIE (LPN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:HOLNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 LOCUSTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1409
Mailing Address - Country:US
Mailing Address - Phone:347-998-6998
Mailing Address - Fax:
Practice Address - Street 1:19 LOCUSTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-1409
Practice Address - Country:US
Practice Address - Phone:347-998-6998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274611-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse