Provider Demographics
NPI:1508842998
Name:MARGOCEE, KAY (NP)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:MARGOCEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1334
Mailing Address - Country:US
Mailing Address - Phone:304-394-1132
Mailing Address - Fax:
Practice Address - Street 1:8700 MANCHACA RD
Practice Address - Street 2:SUITE105
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5371
Practice Address - Country:US
Practice Address - Phone:514-348-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN25480-FNP-BC363LF0000X
WV25480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001732076OtherWV BCBS
WV1058263OtherWV DWC
WV3810002625Medicaid
WV001732076OtherWV BCBS
WV08492Medicare PIN
WV1058263OtherWV DWC
WV08493Medicare PIN
WV08494Medicare PIN