Provider Demographics
NPI:1770967580
Name:MABIE, MARGARET D (MS,APRN,FNP-C,PMHNP-)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:D
Last Name:MABIE
Suffix:
Gender:F
Credentials:MS,APRN,FNP-C,PMHNP-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 HICKS ROAD
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27505-8267
Mailing Address - Country:US
Mailing Address - Phone:919-609-8721
Mailing Address - Fax:
Practice Address - Street 1:505 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5616
Practice Address - Country:US
Practice Address - Phone:252-212-5524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007694363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1770967580Medicaid