Provider Demographics
NPI:1043236912
Name:MARGLES, ELLEN S (CNM)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:S
Last Name:MARGLES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 S 1470 E STE 300
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1962
Mailing Address - Country:US
Mailing Address - Phone:435-674-0999
Mailing Address - Fax:435-674-0960
Practice Address - Street 1:295 S 1470 E STE 300
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1962
Practice Address - Country:US
Practice Address - Phone:435-674-0999
Practice Address - Fax:435-674-0960
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221216OtherUNISON
OH737687OtherBUCKEYE
OH5428054OtherAETNA
OH000000509175OtherANTHEM
OH363804OtherWELLCARE
OH0894939Medicaid
OH0894939Medicaid
OHMANM00017Medicare PIN
OH363804OtherWELLCARE
OHP00747252Medicare PIN