Provider Demographics
NPI:1275515363
Name:AUBIN, MARGARET RUTH (FNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:RUTH
Last Name:AUBIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-9607
Mailing Address - Country:US
Mailing Address - Phone:360-416-3322
Mailing Address - Fax:
Practice Address - Street 1:205 STEWART RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-9607
Practice Address - Country:US
Practice Address - Phone:360-416-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN032217AP04266363LA2200X, 363LF0000X
WAAP60189618363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1165000Medicaid
LAP00916204Medicare PIN
LA4C855Medicare ID - Type Unspecified
LA1165000Medicaid