Provider Demographics
NPI:1033947585
Name:IVIMEY, MARGARET KATHLEEN (RN)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:IVIMEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-2385
Mailing Address - Country:US
Mailing Address - Phone:518-891-3950
Mailing Address - Fax:
Practice Address - Street 1:159 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-2385
Practice Address - Country:US
Practice Address - Phone:518-891-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY509520163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)