Provider Demographics
NPI:1386843407
Name:EMBRY, MARGARET BLAKE (RN, MSN, CFNP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:BLAKE
Last Name:EMBRY
Suffix:
Gender:F
Credentials:RN, MSN, CFNP
Other - Prefix:
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Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:551 AZALEA DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-7900
Practice Address - Country:US
Practice Address - Phone:662-636-5335
Practice Address - Fax:662-636-5337
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS864248363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS64-0606089OtherTAX ID