Provider Demographics
NPI:1891184628
Name:MARSHALL, ANECIA (NP)
Entity type:Individual
Prefix:
First Name:ANECIA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 NAPOLEON AVE
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-6100
Mailing Address - Country:US
Mailing Address - Phone:337-662-5248
Mailing Address - Fax:337-662-7290
Practice Address - Street 1:990 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6100
Practice Address - Country:US
Practice Address - Phone:337-662-5248
Practice Address - Fax:337-662-7290
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO8110363LF0000X
LAAP08110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily