Provider Demographics
NPI:1134438161
Name:DANIEL, MARGARET L (CRNA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:L
Last Name:DANIEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:GRIMBALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:632 N 12TH ST # 230
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-1651
Mailing Address - Country:US
Mailing Address - Phone:731-431-3243
Mailing Address - Fax:
Practice Address - Street 1:632 N 12TH ST # 230
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1651
Practice Address - Country:US
Practice Address - Phone:831-431-3243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006604367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK014610Medicare Oscar/Certification