Provider Demographics
NPI:1245780386
Name:CROSS, MARGARET (NIC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:NIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 SNAFFLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1017
Mailing Address - Country:US
Mailing Address - Phone:859-285-7617
Mailing Address - Fax:
Practice Address - Street 1:3402 SNAFFLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1017
Practice Address - Country:US
Practice Address - Phone:859-285-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY125145171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter