MEDICARE: MARIAGORETY NWILOH NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	PMH07250102	TX
2	363LF0000X	Family Nurse Practitioner	846104	TX

General Provider Information

NPI Number	:	1740604560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAGORETY NWILOH NP

Provider Business Mailing Address
First Line	:	PO BOX 963207
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79996-3207
Country	:	US
Telephone Number	:	915-300-2276
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 JOE BATTLE BLVD # D203
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4660
Country	:	US
Telephone Number	:	915-300-2276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	08/06/2025

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