MEDICARE: MARGARET VANESSA NAHAMYA FNP-BC

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	363LF0000X	Family Nurse Practitioner	NP95032160	CA

General Provider Information

NPI Number	:	1871313668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET VANESSA NAHAMYA FNP-BC

Provider Business Mailing Address
First Line	:	25052 PINE MOUNTAIN TER
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-3097
Country	:	US
Telephone Number	:	714-420-8815
Fax Number	:

Provider Business Practice Location Address
First Line	:	25052 PINE MOUNTAIN TER
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-3097
Country	:	US
Telephone Number	:	714-420-8815
Fax Number	:

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

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	10/15/2024

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