| Organization Name: | PROVIDER PLUS LLC |
| NPI Number: | 1548318249 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON F MARSHALL (OWNER) |
| Mailing Address: | 3723 Willow Springs Dr Manvel |
| State: | TX US |
| Postal Code: | 775784787 |
| Phone Number: | 8322642133 |
| Fax Number: | 2814859817 |
| NPI Enumeration Date: | 01/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SG0600X |
| License Number: | 513451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |