Provider Demographics
NPI:1457313900
Name:CONSTANTE, MARGARET J (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:CONSTANTE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:44 MEDICAL PARK BLVD STE A
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9351
Practice Address - Country:US
Practice Address - Phone:804-324-4511
Practice Address - Fax:804-835-5103
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017138217207N00000X
VA0024166338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010114675Medicaid
005950C39Medicare ID - Type Unspecified
Q30004Medicare UPIN