Provider Demographics
NPI:1619177599
Name:VANANTWERP, MARGARET (CNP)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:
Last Name:VANANTWERP
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ELLIOTT BARKER
Mailing Address - Street 2:
Mailing Address - City:ANGEL FIRE
Mailing Address - State:NM
Mailing Address - Zip Code:87710
Mailing Address - Country:US
Mailing Address - Phone:505-377-3301
Mailing Address - Fax:575-377-3991
Practice Address - Street 1:11 ELLIOTT BARKER
Practice Address - Street 2:
Practice Address - City:ANGEL FIRE
Practice Address - State:NM
Practice Address - Zip Code:87710
Practice Address - Country:US
Practice Address - Phone:505-377-3301
Practice Address - Fax:575-377-3991
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR60851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily