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General NPI Number Information
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NPI Number | 1407509276
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Entity Type | Individual
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Provider Name | MILAGROS MARSHALL
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 520 KNOLLWOOD
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City | GRIFFIN
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State | GA
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Zip | 30224-4562
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Country | US
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Telephone | 770-990-8170
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40412
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City | BELFAST
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State | ME
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Zip | 04915-1255
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Country | US
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Telephone | 470-964-1700
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AG12210070
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License Number State | GA
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