Provider Demographics
NPI:1750576922
Name:MARGULIES, IMELDA G (APRN)
Entity type:Individual
Prefix:
First Name:IMELDA
Middle Name:G
Last Name:MARGULIES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7714 CONNER RD STE 107
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3559
Mailing Address - Country:US
Mailing Address - Phone:865-692-1610
Mailing Address - Fax:865-692-1619
Practice Address - Street 1:7714 CONNER RD STE 107
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3559
Practice Address - Country:US
Practice Address - Phone:865-692-1610
Practice Address - Fax:865-692-1619
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12151363L00000X, 363LF0000X
TNRN0000087743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN0000087743OtherSTATE LICENSE NO