Provider Demographics
NPI:1750109096
Name:SHUPE, MARGARET E (FNP-BC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:SHUPE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:E
Other - Last Name:JARRETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1202 N SADDLEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-2483
Mailing Address - Country:US
Mailing Address - Phone:574-270-0894
Mailing Address - Fax:
Practice Address - Street 1:692 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MONON
Practice Address - State:IN
Practice Address - Zip Code:47959-8191
Practice Address - Country:US
Practice Address - Phone:800-321-5043
Practice Address - Fax:877-727-7640
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015967A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily