MEDICARE: DAKOTA J MARSHALL

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1720928799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKOTA J MARSHALL

Provider Business Mailing Address
First Line	:	1700 MEDICAL CENTER PKWY
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-2245
Country	:	US
Telephone Number	:	615-396-6901
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 MADISON AVENUE SUITE 447
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-3438
Country	:	US
Telephone Number	:	615-396-6901
Fax Number	:

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

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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