Healthcare Provider Details

I. General information

NPI: 1760035810
Provider Name (Legal Business Name): MARGARITA M MARMOLEJO DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 SEABOARD RD STE 105
VIRGINIA BEACH VA
23456-3500
US

IV. Provider business mailing address

2401 SEABOARD RD STE 105
VIRGINIA BEACH VA
23456-3500
US

V. Phone/Fax

Practice location:
  • Phone: 757-430-4270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024179977
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: