Provider Demographics
NPI:1831628957
Name:MARSHALL, BETH ANN (NP-C)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 CHESTNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7460
Mailing Address - Country:US
Mailing Address - Phone:330-416-1316
Mailing Address - Fax:
Practice Address - Street 1:525 EAST MARKET STREET
Practice Address - Street 2:SUMMA HEALTH SYSTEM
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-4425
Practice Address - Country:US
Practice Address - Phone:330-375-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN256986207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1831628957Medicaid