Provider Demographics
NPI:1588281422
Name:NNANDILOBI, MARGARET GINIKANWA
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:GINIKANWA
Last Name:NNANDILOBI
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 1:3310 LIVE OAK ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6149
Mailing Address - Country:US
Mailing Address - Phone:972-942-3410
Mailing Address - Fax:972-942-3411
Practice Address - Street 1:3310 LIVE OAK ST STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6149
Practice Address - Country:US
Practice Address - Phone:972-942-3410
Practice Address - Fax:972-942-3411
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000917363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty