Provider Demographics
NPI:1407801780
Name:SLAPE, MARGARET M (APN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:SLAPE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-0879
Mailing Address - Country:US
Mailing Address - Phone:479-713-7115
Mailing Address - Fax:479-713-7186
Practice Address - Street 1:3215 N NORTHHILLS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4007
Practice Address - Country:US
Practice Address - Phone:479-463-5500
Practice Address - Fax:479-463-5542
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP01326363LW0102X
ARM00117367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W469OtherBLUE
AR5W469Medicare ID - Type Unspecified
B30180Medicare UPIN