Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | LP-0000184 | DE |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | LP-0000184 | DE |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP022040 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | LP-0000184 | DE |
NPI | 1396293254 |
---|---|
Provider Name | Margaret Roth |
First Address | Philadelphia, PA 19104-2640 |
Second Address | Philadelphia, PA 19104-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2016 |
Last Update Date | 22/01/2021 |