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General NPI Number Information
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NPI Number | 1124630785
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Entity Type | Individual
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Provider Name | HALEY LYNN MARSHALL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 9520 FIELDS ERTEL RD
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City | LOVELAND
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State | OH
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Zip | 45140-6270
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Country | US
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Telephone | 513-583-9273
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Fax |
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Provider Business Mailing Address
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Address Line | 2485 EDGEWATER DR APT 3
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City | BEAVERCREEK
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State | OH
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Zip | 45431-5646
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Country | US
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Telephone | 614-371-9140
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 021397
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03439706
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License Number State | OH
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