Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704250280 | MI |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704250280 | MI |
NPI | 1063840601 |
---|---|
Provider Name | Margaret Diane Barden |
First Address | Chicago, IL 60607-1644 |
Second Address | Southgate, MI 48195-1332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2013 |
Last Update Date | 27/02/2019 |