Provider Demographics
NPI:1619397189
Name:THERRELL, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:THERRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 JETS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-3256
Mailing Address - Country:US
Mailing Address - Phone:864-378-0081
Mailing Address - Fax:
Practice Address - Street 1:1092 JETS LANDING RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-3256
Practice Address - Country:US
Practice Address - Phone:864-378-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN61715163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse