Healthcare Provider Details

I. General information

NPI: 1023292067
Provider Name (Legal Business Name): CHELSEA GENNA MARSHALL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E 770 N
OREM UT
84097-4102
US

IV. Provider business mailing address

501 E 770 N
OREM UT
84097-4102
US

V. Phone/Fax

Practice location:
  • Phone: 801-724-9840
  • Fax: 801-235-1509
Mailing address:
  • Phone: 801-724-9840
  • Fax: 801-235-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number71069781206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: