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NPI Code Detail

MEDICARE: MARGARET O'BERRY

MEDICARE: MARGARET O'BERRY
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
1163W00000XRegistered Nurse149668GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1149668OTHERGARN

General Provider Information

NPI Number : 1154620524
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET O'BERRY
Provider Business Mailing Address
First Line : 3120 N OAK STREET EXT STE C
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-5910
Country : US
Telephone Number : 229-671-6100
Fax Number : 229-671-6774
Provider Business Practice Location Address
First Line : 1905 S HUTCHINSON AVE
Second Line :
City : ADEL
State : GA
Zip : 31620-5246
Country : US
Telephone Number : 229-896-4559
Fax Number : 229-896-8367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2011
Last Update Date : 03/24/2011

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Directions to “ MARGARET O'BERRY ” Practice Location

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