Provider Demographics
NPI:1578184933
Name:NAHASS, MARGARET M (PA-C, RN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:NAHASS
Suffix:
Gender:F
Credentials:PA-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 TALL MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:FREEBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62243-4078
Mailing Address - Country:US
Mailing Address - Phone:618-401-5700
Mailing Address - Fax:
Practice Address - Street 1:601 JAMES R THOMPSON BLVD STE 2015
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62201-1118
Practice Address - Country:US
Practice Address - Phone:618-482-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041240666163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice