Provider Demographics
NPI:1780162016
Name:HAVILAND, MARGARET (CNM)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:HAVILAND
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1819
Mailing Address - Country:US
Mailing Address - Phone:484-441-3272
Mailing Address - Fax:
Practice Address - Street 1:1217 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1819
Practice Address - Country:US
Practice Address - Phone:484-441-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010488367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife