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General NPI Number Information
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NPI Number | 1528555216
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Entity Type | Individual
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Provider Name | GREGORY MARSHALL FNP-C
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Gender | Male
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 4411 WASHINGTON AVE STE 100
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City | EVANSVILLE
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State | IN
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Zip | 47714-0805
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Country | US
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Telephone | 812-437-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 29943 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1299
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Country | US
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Telephone | 317-726-7246
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Fax | 317-706-3417
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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 | 28207276A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 71007920A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 28207276A
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License Number State | IN
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