| Doctor Name: | SHANDA R. MARSHALL |
| NPI Number: | 1265761340 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP-BC |
| License Number: | 702935 |
| Business Practice Address: | 412 Th Medical Grouup 30 Nightingale Road Edwards, CA - 935240001 |
| Business Phone Number: | 6612752722 |
| Business Fax Number: | |
| Mailing Address: | 412 Th Medical Group, 30 Nightingale Road EDWARDS |
| State: | CA |
| Postal Code: | 935240001 |
| Phone Number: | 6612752722 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2009 |
| NPI Last Update Date: | 09/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 702935 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |