Healthcare Provider Details

I. General information

NPI: 1699089094
Provider Name (Legal Business Name): MARGARET KOWALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 POSADA LN STE A
TEMPLETON CA
93465-4057
US

IV. Provider business mailing address

262 POSADA LN STE A
TEMPLETON CA
93465-4057
US

V. Phone/Fax

Practice location:
  • Phone: 805-434-3737
  • Fax: 805-434-1138
Mailing address:
  • Phone: 805-434-3737
  • Fax: 805-434-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN462643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: