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General NPI Number Information
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NPI Number | 1790041747
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Entity Type | Individual
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Provider Name | MARGARITA WYCKO N.N.P.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 9300 DEWITT LOOP
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City | FORT BELVOIR
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State | VA
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Zip | 22060-5285
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Country | US
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Telephone | 571-231-4789
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Fax |
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Provider Business Mailing Address
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Address Line | 9300 DEWITT LOOP OAKS, 5TH FLOOR, ROOM O5.343C
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City | FORT BELVOIR
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State | VA
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Zip | 22060-5285
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Country | US
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Telephone | 571-231-4729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 0024169315
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License Number State | VA
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