Provider Demographics
NPI:1164993853
Name:PETRY, MARGARET A (APRN-CNM)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:A
Last Name:PETRY
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:A
Other - Last Name:PETRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-CNM
Mailing Address - Street 1:254 MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6333
Mailing Address - Country:US
Mailing Address - Phone:910-353-4333
Mailing Address - Fax:910-353-6529
Practice Address - Street 1:254 MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-4333
Practice Address - Fax:910-353-6529
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife