Healthcare Provider Details

I. General information

NPI: 1801898911
Provider Name (Legal Business Name): MARGARET ANNE LASKIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 ACADEMY ST S
AHOSKIE NC
27910-3263
US

IV. Provider business mailing address

211 CHOWAN SHORES DR
COLERAIN NC
27924-9324
US

V. Phone/Fax

Practice location:
  • Phone: 252-862-4054
  • Fax: 252-862-4263
Mailing address:
  • Phone: 252-356-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200711
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: