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General NPI Number Information
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NPI Number | 1376140517
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Entity Type | Individual
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Provider Name | KATHERYN SUE MARSH
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Gender | Female
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 70 GRACELAND DR.
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City | ELKINS
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State | WV
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Zip | 26241
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Country | US
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Telephone | 304-473-5626
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Fax |
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Provider Business Mailing Address
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Address Line | 94 W MAIN ST STE 202
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City | BUCKHANNON
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State | WV
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Zip | 26201-2376
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Country | US
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Telephone | 304-460-7925
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 106830
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License Number State | WV
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