Doctor Name: | JENNY K MARSDEN |
NPI Number: | 1164678660 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | PAC0398 |
Business Practice Address: | 1301 8th St S Moorhead, MN - 565603604 |
Business Phone Number: | 7012343260 |
Business Fax Number: | |
Mailing Address: | 1301 8th St S, MOORHEAD |
State: | MN |
Postal Code: | 565603604 |
Phone Number: | 7012343260 |
Fax Number: | |
NPI Enumeration Date: | 08/15/2008 |
NPI Last Update Date: | 10/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PAC0398 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |