Provider Demographics
NPI:1538126180
Name:O'GRADY, MARGARET A (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:O'GRADY
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 1:1481 W 10TH ST
Mailing Address - Street 2:C & P
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-3691
Mailing Address - Fax:317-988-4696
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:C&P
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-3691
Practice Address - Fax:317-988-4696
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001457363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200345320Medicaid
IN264910GCMedicare PIN
INP88476Medicare UPIN