Provider Demographics
NPI:1386737310
Name:OCONNELL, MARGARET A (CRNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:OCONNELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7114 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3250
Mailing Address - Country:US
Mailing Address - Phone:484-476-1000
Mailing Address - Fax:215-298-5001
Practice Address - Street 1:7114 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-3250
Practice Address - Country:US
Practice Address - Phone:215-298-5000
Practice Address - Fax:215-298-5001
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003587P363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA440771OtherMLHC MEDICARE AA #
PA23-2359401OtherMLHC TIN
PA088781HK1Medicare PIN