Healthcare Provider Details

I. General information

NPI: 1669602314
Provider Name (Legal Business Name): MARGARET H JOHNSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 OLD WILLIAMSBURG RD
YORKTOWN VA
23690-3910
US

IV. Provider business mailing address

1620 OLD WILLIAMSBURG RD
YORKTOWN VA
23690-3910
US

V. Phone/Fax

Practice location:
  • Phone: 757-886-0608
  • Fax:
Mailing address:
  • Phone: 757-886-0608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024169354
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0017140070
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: