Provider Demographics
NPI:1740559608
Name:CONVERSE, MARGARET MARY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARY
Last Name:CONVERSE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 VALLEY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-9344
Mailing Address - Country:US
Mailing Address - Phone:585-223-7392
Mailing Address - Fax:
Practice Address - Street 1:600 PARDEE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-2810
Practice Address - Country:US
Practice Address - Phone:585-339-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224536164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse