Provider Demographics
NPI:1568489342
Name:RAISH, MARGARET S (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:S
Last Name:RAISH
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Mailing Address - Street 1:1501 KINGS HWY
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-4228
Mailing Address - Country:US
Mailing Address - Phone:318-675-7737
Mailing Address - Fax:318-675-5666
Practice Address - Street 1:410 W. 70TH STREET
Practice Address - Street 2:LINWOOD SCHOOL BASED HEALTH CENTER
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106
Practice Address - Country:US
Practice Address - Phone:318-868-4552
Practice Address - Fax:318-868-4552
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN054789363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1695912Medicaid
LA1695912Medicaid
LA4H268F600Medicare ID - Type Unspecified