Provider Demographics
NPI:1538725189
Name:SLAGLE, MARGARET ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:SLAGLE
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 1:4107 GILLIAT ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-2141
Mailing Address - Country:US
Mailing Address - Phone:218-576-6091
Mailing Address - Fax:
Practice Address - Street 1:167 FARLEY LN
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-1526
Practice Address - Country:US
Practice Address - Phone:218-724-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-18
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0960043163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00000000OtherBLUE CROSS