Healthcare Provider Details

I. General information

NPI: 1164594503
Provider Name (Legal Business Name): FLORINE MARSHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3902 ANNAPOLIS RD
BALTIMORE MD
21227-2210
US

IV. Provider business mailing address

4200 PINEFIELD CT
RANDALLSTOWN MD
21133-5324
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-1075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberR136929
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: