Most Relevant Information
Provider Data
| NPI Number: | 1003512856 |
| Provider Name: | BENJAMIN OWEN MARSHALL MSN, FNP-BC, CPHQ |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704371368 |
Most Important Dates
| Enumeration Date: | 02/03/2023 |
| Last Updated: | 08/25/2024 |
Provider Practice Location
3500 COOLIDGE RD
EAST LANSING
MI
488236376
Practice Location Phone/Fax
| Phone: | 5179407615 |
| Fax: |
Provider Mailing Location
10500 B DR N
CERESCO
MI
490339633
Provider Mailing Phone/Fax
| Phone: | 5178973705 |
| Fax: |