Marshall Eugene Earl, RN

Individual provider Active NPI Registered Nurse · Tuba City, AZ

NPI 1992044259 · NPPES record last updated Feb 6, 2013

Key facts

NPI
1992044259
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN159319 (AZ)
Practice address
167 North Main Street
Tuba City, AZ 86045-0600
Phone
(928) 283-2781
Fax
(928) 283-2677
NPI assigned
Feb 6, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN159319AZMDRegistered Nurse
688164CAMDRegistered Nurse
041287209ILMDRegistered Nurse
618762TXMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN159319 AZ Yes
Registered Nurse 163W00000X 618762 TX
Registered Nurse 163W00000X 688164 CA
Registered Nurse 163W00000X 041287209 IL

Addresses

Primary practice location

167 North Main Street
Tuba City, AZ 86045-0600

Mailing address

PO Box 600
PFS Business Office
Tuba City, AZ 86045-0600
Phone (928) 283-2094

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 6, 2013.

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1992044259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "address_2": "PFS BUSINESS OFFICE",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2094",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 NORTH MAIN STREET",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2781",
            "fax_number": "928-283-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARL",
        "first_name": "MARSHALL",
        "middle_name": "EUGENE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN159319",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "618762",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "688164",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041287209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuba City, AZ

All providers in Tuba City, AZ · Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.