Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0024095834 | VA |
NPI | 1083609580 |
---|---|
Provider Name | Margaret Jeanne Brandquist |
First Address | Leesburg, VA 20176-2704 |
Second Address | Dulles, VA 20166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 14/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010024382 | (05) | VA |