MEDICARE: MARGARET LEVERETT, RNCNP, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	NP223A	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972615466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARGARET LEVERETT, RNCNP, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 2426
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83403-2426
Country	:	US
Telephone Number	:	208-525-2090
Fax Number	:	208-523-8978

Provider Business Practice Location Address
First Line	:	2305 CORONADO STREET
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404
Country	:	US
Telephone Number	:	208-535-9009
Fax Number	:	208-535-9020

Authorized Official
Title or Position	:	OWNER
Name	:	MARGARET LEVERETT
Credential	:	RNCNP
Telephone Number	:	208-535-9009

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	09/14/2016

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