MEDICARE: COLENE E MARSHALL ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	45773	KS
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	1368499032	KS
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R237865	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14942	OTHER	KS	PREFERRED HEALTH SYSTEMS
2	161554	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1417900507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLENE E MARSHALL ARNP

Provider Business Mailing Address
First Line	:	PO BOX 99
Second Line	:
City	:	CONOWINGO
State	:	MD
Zip	:	21918-0099
Country	:	US
Telephone Number	:	410-378-9696
Fax Number	:	410-378-0787

Provider Business Practice Location Address
First Line	:	2675 S ABILENE ST STE 100
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2363
Country	:	US
Telephone Number	:	720-507-4779
Fax Number	:	833-941-5047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	08/20/2024

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Directions to “ COLENE E MARSHALL ARNP” Practice Location

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