Ethel Anne Marshall, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP-78682 Issued in ID

Practice address

4614 N Savannah LN
Boise, ID 83714-7405

Phone

(208) 901-6691

NPI assigned

Oct 11, 2023

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Anne Marshall Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rekindled Spirit Marshall Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, ID
  • NPI 1043057359
  NPD Authorized official
• Access Behavioral Health Services, Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Boise, ID
  • NPI 1962018564
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1639950918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 SAVANNAH LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837147405",
            "telephone_number": "208-901-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4614 N SAVANNAH LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837147405",
            "telephone_number": "208-901-6691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N Allumbaugh St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049208",
            "country_code": "US",
            "telephone_number": "208-377-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ETHEL",
        "middle_name": "ANNE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "78682",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "CNP-78682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "MARSHALL",
            "credential": "PMHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christina Marselian
• Daniel Richard Marsh, MD
• Kristin Marsh, RN, IBCLC
• Marian M Marsh, PA-C
• Ryan Marsh, DPT
• Jaime Rochelle Marshall, LCSW
• Timothy Michael Marshall Jr., MD
• Veronica Marshall, LPC
• Megan Taylor Marson, PA-C
• Megan L Marstaeller, MD

• Psychiatric/Mental Health Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.