Provider Demographics
NPI:1700993243
Name:BROCKSON, MARGARET ELLEN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELLEN
Last Name:BROCKSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 CANDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-0307
Mailing Address - Country:US
Mailing Address - Phone:785-539-6497
Mailing Address - Fax:
Practice Address - Street 1:600 CAISSON HILL ROAD
Practice Address - Street 2:
Practice Address - City:FT. RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442
Practice Address - Country:US
Practice Address - Phone:785-239-7499
Practice Address - Fax:785-239-7240
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44998363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology