Healthcare Provider Details

I. General information

NPI: 1619679057
Provider Name (Legal Business Name): CHRISTA MARSHALL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 W JUDGE PEREZ DR
CHALMETTE LA
70043
US

IV. Provider business mailing address

5900 BALCONES DR # 21216
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 504-596-9520
  • Fax:
Mailing address:
  • Phone: 504-251-5073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1152746
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number229436
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: