Provider Demographics
NPI:1255680856
Name:VINES, MARGARET ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:VINES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 GIENOW RD
Mailing Address - Street 2:P.O. BOX 662
Mailing Address - City:RURAL RETREAT
Mailing Address - State:VA
Mailing Address - Zip Code:24368-3210
Mailing Address - Country:US
Mailing Address - Phone:276-228-6499
Mailing Address - Fax:276-228-6145
Practice Address - Street 1:445 GIENOW RD
Practice Address - Street 2:
Practice Address - City:RURAL RETREAT
Practice Address - State:VA
Practice Address - Zip Code:24368-3210
Practice Address - Country:US
Practice Address - Phone:276-228-6499
Practice Address - Fax:276-228-6145
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily