Provider Demographics
NPI:1962807602
Name:SPARE, MARGARET
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:
Last Name:SPARE
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 1:600 MEDICAL CENTER DR
Mailing Address - Street 2:FOOD AND NUTRITION SERVICES
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8780
Mailing Address - Country:US
Mailing Address - Phone:316-804-6184
Mailing Address - Fax:316-804-6276
Practice Address - Street 1:600 MEDICAL CENTER DR
Practice Address - Street 2:FOOD AND NUTRITION SERVICES
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8780
Practice Address - Country:US
Practice Address - Phone:316-804-6184
Practice Address - Fax:316-804-6276
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRD 620-279133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered