Provider Demographics
NPI:1104853050
Name:HART, MARGARET C (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:C
Last Name:HART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1500
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2333 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:IBERIA
Practice Address - State:MO
Practice Address - Zip Code:65486
Practice Address - Country:US
Practice Address - Phone:573-793-6900
Practice Address - Fax:573-793-6688
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086955363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO135570018OtherMEDICARE PTAN
OK100028070AMedicaid
MO428676803Medicaid
KS100301480AMedicaid
MOP00780874OtherRAILROAD MEDICAID
OK100028070AMedicaid
MO135570018OtherMEDICARE PTAN