Provider Demographics
NPI:1821199373
Name:WEST, MARGARET MAYREE (NUTRITIONALIST)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MAYREE
Last Name:WEST
Suffix:
Gender:F
Credentials:NUTRITIONALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 COL RD 432 SOUTH
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753
Mailing Address - Country:US
Mailing Address - Phone:870-234-3488
Mailing Address - Fax:870-234-3488
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2415
Practice Address - Country:US
Practice Address - Phone:870-235-3473
Practice Address - Fax:870-235-3667
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X019Medicare ID - Type UnspecifiedMEDICARE PROVIDER