Healthcare Provider Details

I. General information

NPI: 1366830358
Provider Name (Legal Business Name): MARGUERITE JOSIAH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1438 N MAIN ST UNIT 2134
MADISON VA
22727-2389
US

IV. Provider business mailing address

PO BOX 2134
MADISON VA
22727-2134
US

V. Phone/Fax

Practice location:
  • Phone: 909-559-6020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number444092
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024197002
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: