Provider Demographics
NPI:1841214335
Name:BROTHERS, MARGARET J (RN, CS)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:J
Last Name:BROTHERS
Suffix:
Gender:F
Credentials:RN, CS
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:J
Other - Last Name:BROTHERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, CS
Mailing Address - Street 1:1430 OLIVE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-2303
Mailing Address - Country:US
Mailing Address - Phone:573-756-5353
Mailing Address - Fax:573-756-4557
Practice Address - Street 1:1085 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1955
Practice Address - Country:US
Practice Address - Phone:573-756-5353
Practice Address - Fax:573-756-4557
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115567364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health