Marshall, Kathleen Bridget

Marshall, Kathleen Bridget is an individual health care provider with primary practice located at 717 Mission Rd. , Fort Hall ID 83203-0717. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Marshall, Kathleen Bridget can be contacted via phone (208) 238-5435.

Contact Information

Primary practice address
717 Mission Rd. Fort Hall ID 83203-0717
Phone: (208) 238-5435
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X NP433A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X NP433A Idaho

Profile Details

NPI number 1568679603
LBN Legal business name Marshall, Kathleen Bridget
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568679603 NPPES
Idaho MEDICAID 8063500
Idaho MEDICAID 8064977
Idaho MEDICAID 80662922

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