Healthcare Provider Details

I. General information

NPI: 1346559010
Provider Name (Legal Business Name): JANET M MARSHALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANET M EVANS

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5366 BEAR RD
NORTH SYRACUSE NY
13212-1238
US

IV. Provider business mailing address

5366 BEAR ROAD
NORTH SYRACUSE NY
13212
US

V. Phone/Fax

Practice location:
  • Phone: 315-452-3221
  • Fax:
Mailing address:
  • Phone: 315-452-3221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number439422-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: