Provider Demographics
NPI:1770131336
Name:DUSOLD, MARGARET A
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:DUSOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21827 E CREOSOTE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4932
Mailing Address - Country:US
Mailing Address - Phone:480-430-8675
Mailing Address - Fax:
Practice Address - Street 1:21827 E CREOSOTE DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4932
Practice Address - Country:US
Practice Address - Phone:480-430-8675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP040023164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse