1093921835 NPI number — MARGARET DIANE HAWKINS MCCRIGHT APN

Table of content: MARGARET DIANE HAWKINS MCCRIGHT APN (NPI 1093921835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093921835 NPI number — MARGARET DIANE HAWKINS MCCRIGHT APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCRIGHT
Provider First Name:
MARGARET DIANE
Provider Middle Name:
HAWKINS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCCRIGHT
Provider Other First Name:
DIANE
Provider Other Middle Name:
H.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1093921835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1171 7TH ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50314-2505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-280-7004
Provider Business Mailing Address Fax Number:
515-280-9525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5921 W. 12TH ST.
Provider Second Line Business Practice Location Address:
STE. C
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72204-1623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-801-0001
Provider Business Practice Location Address Fax Number:
501-801-0205
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R0054285 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: A03249ANP , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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