Provider Demographics
NPI:1083196547
Name:ANNAN, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:ANNAN
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 1:1213 WATERS DAIRY RD APT 516
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3442
Mailing Address - Country:US
Mailing Address - Phone:347-295-6179
Mailing Address - Fax:
Practice Address - Street 1:1213 WATERS DAIRY RD APT 516
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3442
Practice Address - Country:US
Practice Address - Phone:347-295-6179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68441164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse