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General NPI Number Information
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NPI Number | 1194731869
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Entity Type | Individual
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Provider Name | MARGARET ALICE ANTLEY P.A. - C
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 710 S 17TH ST
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City | OMAHA
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State | NE
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Zip | 68102-3108
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Country | US
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Telephone | 402-599-2309
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Fax |
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Provider Business Mailing Address
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Address Line | 9610 LINDEN AVE
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City | BELLEVUE
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State | NE
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Zip | 68147-2369
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Country | US
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Telephone | 402-731-8228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1076
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License Number State | NE
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