Most Relevant Information
Provider Data
| NPI Number: | 1003578568 |
| Provider Name: | MARSHALL BARR BERGEN CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | RN192249 |
Most Important Dates
| Enumeration Date: | 10/12/2021 |
| Last Updated: | 02/17/2022 |
Provider Practice Location
4605 E ELWOOD ST STE 500
PHOENIX
AZ
850401978
Practice Location Phone/Fax
| Phone: | 4802561518 |
| Fax: | 4803043446 |
Provider Mailing Location
1526 E BEACON DR
GILBERT
AZ
852342674
Provider Mailing Phone/Fax
| Phone: | 4802822011 |
| Fax: |