Provider Demographics
NPI:1851725972
Name:MACDONALD, MARGUERITE EMILY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:EMILY
Last Name:MACDONALD
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 1:5215 WILLOWVIEW RD
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-2257
Mailing Address - Country:US
Mailing Address - Phone:262-939-5216
Mailing Address - Fax:
Practice Address - Street 1:5215 WILLOWVIEW RD
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-2257
Practice Address - Country:US
Practice Address - Phone:262-939-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI310929-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse