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NPI Code Detail

MEDICARE: HEATHER M MARSHALL RN, MSN CNP

MEDICARE:   HEATHER M MARSHALL  RN, MSN CNP
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
1163W00000XRegistered NurseRN.293630OH
2363LF0000XFamily Nurse PractitionerCOA.14724-NPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710228606
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER M MARSHALL RN, MSN CNP
Provider Business Mailing Address
First Line : 3170 KETTERING BLVD BLDG B
Second Line :
City : MORAINE
State : OH
Zip : 45439-1924
Country : US
Telephone Number : 937-991-3188
Fax Number :
Provider Business Practice Location Address
First Line : 2600 MOTE DR
Second Line :
City : COVINGTON
State : OH
Zip : 45318-1260
Country : US
Telephone Number : 372-089-0109
Fax Number : 937-208-9020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2013
Last Update Date : 09/30/2025

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