Provider Demographics
NPI:1225363732
Name:ING, MARGIE N
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:N
Last Name:ING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 KIRBY WOODS CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-7616
Mailing Address - Country:US
Mailing Address - Phone:901-652-5211
Mailing Address - Fax:
Practice Address - Street 1:2350 KIRBY WOODS CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-7616
Practice Address - Country:US
Practice Address - Phone:901-652-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108003320172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker