Healthcare Provider Details

I. General information

NPI: 1366425415
Provider Name (Legal Business Name): MARGARET MONTGOMER JONES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8133 RONDELAY LN
FAIRFAX STATION VA
22039
US

IV. Provider business mailing address

8133 RONDELAY LN
FAIRFAX STATION VA
22039-2305
US

V. Phone/Fax

Practice location:
  • Phone: 703-239-0948
  • Fax:
Mailing address:
  • Phone: 703-239-0948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0001066148
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0001066148
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: