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General NPI Number Information
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NPI Number | 1992067649
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Entity Type | Individual
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Provider Name | JESSICA LYNN MARSHALL D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 3 ADVENTHEALTH WAY STE 201
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City | PALM COAST
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State | FL
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Zip | 32137-4702
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Country | US
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Telephone | 386-586-1840
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Fax | 386-586-1841
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Provider Business Mailing Address
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Address Line | 770 W GRANADA BLVD STE 101
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5179
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Country | US
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Telephone |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OS17891
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License Number State | FL
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