Provider Demographics
NPI:1528497906
Name:MOMPLAISIR, MARGARONE (APRN)
Entity type:Individual
Prefix:
First Name:MARGARONE
Middle Name:
Last Name:MOMPLAISIR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0746
Mailing Address - Country:US
Mailing Address - Phone:956-682-6146
Mailing Address - Fax:956-631-0441
Practice Address - Street 1:4302 S SUGAR RD STE 206
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9140
Practice Address - Country:US
Practice Address - Phone:956-682-6146
Practice Address - Fax:956-631-0441
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124329363L00000X
TX716987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3281602-01Medicaid
TX326478YKSJMedicare PIN