Provider Demographics
NPI:1124084116
Name:MCALLISTER, MARGARET LINN
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:LINN
Last Name:MCALLISTER
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 1:109 MAPLE STREET
Mailing Address - Street 2:
Mailing Address - City:BANCROFT
Mailing Address - State:MI
Mailing Address - Zip Code:48414
Mailing Address - Country:US
Mailing Address - Phone:989-634-8331
Mailing Address - Fax:
Practice Address - Street 1:2360 STONEBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5406
Practice Address - Country:US
Practice Address - Phone:810-733-7250
Practice Address - Fax:810-733-8424
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1450136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA50-0-87-6670-0OtherBC PIN NUMBER
MI4374232Medicaid
MI0P09670Medicare ID - Type UnspecifiedMEDICARE PART B/GROUP
MA50-0-87-6670-0OtherBC PIN NUMBER
MIP09670002Medicare ID - Type UnspecifiedMEDICARE PART B/MEMBER #
MI4374232Medicaid