Provider Demographics
NPI:1528648920
Name:MARSHALL, MILENA ANEZKA (DNP, CRNA)
Entity type:Individual
Prefix:DR
First Name:MILENA
Middle Name:ANEZKA
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.S. NAVAL HOSPITAL GUAM
Mailing Address - Street 2:PSC 455 BOX 208
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96540
Mailing Address - Country:US
Mailing Address - Phone:671-344-9340
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL GUAM
Practice Address - Street 2:BLDG 50, FARENHOLT AVENUE
Practice Address - City:AGANA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96910
Practice Address - Country:US
Practice Address - Phone:671-344-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95236926163W00000X
MI4704306408163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse