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NPI Code Detail

MEDICARE: MARGARET HEATON RN

MEDICARE:   MARGARET  HEATON  RN
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 NurseR164540-6MN

General Provider Information

NPI Number : 1952756579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET HEATON RN
Provider Business Mailing Address
First Line : 7511 170TH AVE NE
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-8806
Country : US
Telephone Number : 651-245-8805
Fax Number :
Provider Business Practice Location Address
First Line : 7511 170TH AVE NE
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-8806
Country : US
Telephone Number : 651-245-8805
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2016
Last Update Date : 05/02/2016

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