Provider Demographics
NPI:1386671113
Name:SMITH, MARGARET GATLIN (MS, CRNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:GATLIN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 TWINBROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1748
Mailing Address - Country:US
Mailing Address - Phone:301-770-4444
Mailing Address - Fax:301-770-0538
Practice Address - Street 1:12730 TWINBROOK PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1748
Practice Address - Country:US
Practice Address - Phone:301-770-4444
Practice Address - Fax:301-770-0538
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR080626363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1488-0014OtherAND GLOBAL. BCBS
MDK333-HE 636690-01OtherBCBS MARYLAND