MS. KATHLEEN BRIDGET MARSHALL (NPI# 1568679603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568679603 |
| Entity Type | Individual |
| Full Name | MS. KATHLEEN BRIDGET MARSHALL |
| Credential | CPNP |
| Practice Address |
717 Mission Rd. Fort Hall ID 83203-0717 |
| Mailing Address |
9530 W Heather Rd Pocatello ID 83204-7232 |
| Practice Telephone | 2082385435 |
| Mailing Telephone | 2082337699 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
NP433A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| X | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
NP433A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 8064977 | 05 | |
| ID | 8063500 | 05 | |
| ID | 80662922 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063646586 | Kathleen Blaney Marshall | Internal Medicine | 4700 Nicole Ct, Missoula, MT 59803-2792 | 2009-05-12 |
| 1497941165 | Kathleen Marshall | Pharmacist | 7729 Sw Us Hwy 27, Fort White, FL 32038 | 2007-09-17 |
| 1427591445 | Kathleen Marshall | Massage Therapist | 1026 Ne 117th St, Seattle, WA 98125-5002 | 2016-11-22 |
| 1164658712 | Kathleen Marshall | Psychiatry & Neurology | 2230 Stockton Blvd, Sacramento, CA 95817-1353 | 2009-06-09 |
| 1528034865 | Kathleen Michelle Marshall | Family Medicine | 601 Potomac Station Dr Ne, Leesburg, VA 20176-1816 | 2006-02-27 |
| 1619977949 | Kathleen M Marshall | Nurse Practitioner | 582 New Loudon Rd, Latham, NY 12110-4029 | 2005-07-28 |
| Street Address |
717 MISSION RD. |
| City | FORT HALL |
| State | ID |
| Zip Code | 83203-0717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154765238 | Chief Tahgee Elementary Academy, Inc. | Local Education Agency (LEA) | 38 South Hiline Road, Fort Hall, ID 83203 | 2013-04-19 |
| 1730304171 | Shari L. Newsome | Social Worker | Mission Road Building 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | 2007-04-13 |
| 1780808899 | Scotti L Brownley | Counselor | Mission Road Bldg 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | 2007-04-12 |
| 1932323045 | Kristy Lee Broncho | Social Worker | Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 | 2007-04-12 |
| 1972632834 | Not-tsoo Gah-nee Indian Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Route 6 Mission Rd, Fort Hall, ID 83203 | 2007-03-05 |
| 1346259355 | Holly J Mcgrath | Pharmacist | Mission Rd, Box 717, Fort Hall, ID 83203 | 2006-08-07 |
| 1073518163 | Thomas John Troshynski | Pharmacist | 1 Mission Road, Fort Hall, ID 83203 | 2005-06-16 |
| 1568920080 | Wiley Drew Petersen | Family Medicine | 717 Mission Rd, Fort Hall, ID 83203 | 2019-03-04 |
| 1497262216 | Cameron Jo Marshall | Pharmacist | Mission Road, Fort Hall, ID 83203 | 2018-01-02 |
| 1225570716 | Shoshone-bannock Community Health Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Navajo Drive Bldg 70, Fort Hall, ID 83203 | 2016-11-15 |
| Find all providers in zip 83203 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959100 | Taylor Frances Mello | Nurse Practitioner | 2770 N Woodview Pl, Boise, ID 83702-6541 | 2020-07-17 |
| 1275192205 | Luna Hodges | Nurse Practitioner | 125 E Idaho St Ste 200, Boise, ID 83712-6225 | 2019-06-12 |
| 1740750710 | Nurture Lactation Support for Women & Infants | Nurse Practitioner | 5480 Gleneagles Dr, Idaho Falls, ID 83401-6315 | 2018-12-03 |
| 1790291276 | Bee Happy Pediatrics | Nurse Practitioner | 3412 South 25th East, Idaho Falls, ID 83406-4967 | 2017-12-20 |
| 1376700799 | Monica Hermine Mccullough | Nurse Practitioner | 3525 E Louise Dr Ste 250, Meridian, ID 83642-6303 | 2008-05-22 |
| 1073675617 | Leona Jo'anne' Church | Nurse Practitioner | 1655 W Fairview Ave Ste 206, Boise, ID 83702-5190 | 2006-12-13 |
| 1861477838 | Margaret Anne Fry Lawson | Nurse Practitioner | 637 E Deer Flat Rd, Kuna, ID 83634-3444 | 2005-12-13 |
| 1164411864 | Nancy Norine Miller | Nurse Practitioner | 925 W 1st St, Meridian, ID 83642 | 2005-10-17 |
| 1033102579 | Karen L Godard | Nurse Practitioner | 1305 3rd St S, Nampa, ID 83651-3903 | 2005-08-30 |
| 1386204758 | Aimee Lynn Hastriter | Nurse Practitioner | 125 E Idaho St Ste 200, Boise, ID 83712-6225 | 2019-06-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.