Provider Demographics
NPI:1902212152
Name:SMITH, MARGARET (RN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 HAGOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-1915
Mailing Address - Country:US
Mailing Address - Phone:803-450-5025
Mailing Address - Fax:803-450-5026
Practice Address - Street 1:739 HAGOOD AVE
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-1915
Practice Address - Country:US
Practice Address - Phone:803-450-5025
Practice Address - Fax:803-450-5026
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN278587L163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy