MEDICARE: MS. MARGARET RIGGAN LIGHT NURSE PRACTITIONER

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
1	363LA2200X	Adult Health Nurse Practitioner	0024054663	VA

General Provider Information

NPI Number	:	1578568788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET RIGGAN LIGHT NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1801 ROBERT FULTON DR
Second Line	:	SUITE 140
City	:	RESTON
State	:	VA
Zip	:	20191-5461
Country	:	US
Telephone Number	:	703-876-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 ROBERT FULTON DR
Second Line	:	STE 140
City	:	RESTON
State	:	VA
Zip	:	20191-5461
Country	:	US
Telephone Number	:	703-876-9300
Fax Number	:	703-876-9811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	05/27/2016

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