Provider Demographics
NPI:1184680746
Name:WASHINGTON, MARGARET ANN (ANP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:ANP
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 1285
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-1285
Mailing Address - Country:US
Mailing Address - Phone:870-543-2380
Mailing Address - Fax:870-535-4716
Practice Address - Street 1:1101 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71601-5801
Practice Address - Country:US
Practice Address - Phone:870-543-2380
Practice Address - Fax:870-535-4716
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01141207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR159659758OtherMEDICAID
AR5U042OtherMEDICARE
ARG76651OtherUPIN