Provider Demographics
NPI:1659980647
Name:JORGENSON, MARGARET MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARIE
Last Name:JORGENSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:WEIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16449 149TH ST
Mailing Address - Street 2:
Mailing Address - City:BONNER SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:66012-9377
Mailing Address - Country:US
Mailing Address - Phone:402-682-1812
Mailing Address - Fax:
Practice Address - Street 1:325 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1360
Practice Address - Country:US
Practice Address - Phone:785-505-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS79372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS79372OtherAPRN LICENSE