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NPI Code Detail

MEDICARE: MARY MARGARET NUGENT O.T.R./L

MEDICARE: MARY MARGARET NUGENT O.T.R./L
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
1225X00000XOccupational Therapist01546IA

General Provider Information

NPI Number : 1437554292
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MARGARET NUGENT O.T.R./L
Provider Business Mailing Address
First Line : 33086 E TRAIL RIDGE CIR
Second Line :
City : ADEL
State : IA
Zip : 50003-8465
Country : US
Telephone Number : 515-979-8333
Fax Number :
Provider Business Practice Location Address
First Line : 1204 LINDEN ST
Second Line :
City : DALLAS CENTER
State : IA
Zip : 50063-1052
Country : US
Telephone Number : 515-992-3735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2014
Last Update Date : 10/22/2014

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