Healthcare Provider Details

I. General information

NPI: 1124084116
Provider Name (Legal Business Name): MARGARET LINN MCALLISTER
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 STONEBRIDGE DR
FLINT MI
48532-5406
US

IV. Provider business mailing address

109 MAPLE STREET
BANCROFT MI
48414
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-7250
  • Fax: 810-733-8424
Mailing address:
  • Phone: 989-634-8331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1450136
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: