MEDICARE: ALEXANDRIA MARSHALL RN, BCD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	143509	AL
2	163WX0003X	Inpatient Obstetric Registered Nurse	143509	AL
3	374J00000X	Doula

General Provider Information

NPI Number	:	1184311607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA MARSHALL RN, BCD

Provider Business Mailing Address
First Line	:	6300 GRELOT RD STE G-1426
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-3602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6524 MEADOW LN N
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36618-3605
Country	:	US
Telephone Number	:	251-391-5115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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