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General NPI Number Information
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NPI Number | 1417728130
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Entity Type | Individual
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Provider Name | JSHAUNTAE MARSHALL
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 06/23/2024
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Provider Practice Location Address
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Address Line | 1230 W OWENS AVE STE 1
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City | LAS VEGAS
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State | NV
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Zip | 89106-2451
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Country | US
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Telephone | 725-204-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 8046 PAVAROTTI AVE
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City | LAS VEGAS
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State | NV
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Zip | 89178-8264
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Country | US
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Telephone | 702-337-4793
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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 | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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