Provider Demographics
NPI:1144469750
Name:OUELLETTE, MARGARET ANN (PHYSICAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:OUELLETTE
Suffix:
Gender:F
Credentials:PHYSICAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 4TH ST
Mailing Address - Street 2:FLORENCE CRANE CORRECTIONAL FACILITY
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036
Mailing Address - Country:US
Mailing Address - Phone:517-279-9165
Mailing Address - Fax:
Practice Address - Street 1:38 4TH ST
Practice Address - Street 2:FLORENCE CRANE CORRECTIONAL FACILITY
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036
Practice Address - Country:US
Practice Address - Phone:517-279-9165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004354363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical