Healthcare Provider Details

I. General information

NPI: 1891508461
Provider Name (Legal Business Name): BESSIE MARSHALL AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 CAMARGO RD
CINCINNATI OH
45243-3107
US

IV. Provider business mailing address

308 NEWBURY PL
TRENTON OH
45067-3502
US

V. Phone/Fax

Practice location:
  • Phone: 513-770-0820
  • Fax:
Mailing address:
  • Phone: 937-683-3298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.0038606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: