Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9414902 | FL |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN183351 | GA |
NPI | 1013308311 |
---|---|
Provider Name | Mrs. Margo Renee Gaskins |
First Address | Kathleen, GA 31047 |
Second Address | Montezuma, GA 31063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 15/06/2017 |