Provider Demographics
NPI:1174816938
Name:EAUGALLIE, MARGARET ANNE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:EAUGALLIE
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9027 ARGONNE WAY
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436-9382
Mailing Address - Country:US
Mailing Address - Phone:707-887-7412
Mailing Address - Fax:
Practice Address - Street 1:9027 ARGONNE WAY
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:CA
Practice Address - Zip Code:95436-9382
Practice Address - Country:US
Practice Address - Phone:707-887-7412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370836163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant