Provider Demographics
NPI:1316760689
Name:GARRISON, MARGUERITE (WHNP)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:GARRISON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:JOANNE
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MARGUERITE J KAUL
Mailing Address - Street 1:427 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-2314
Mailing Address - Country:US
Mailing Address - Phone:858-220-4777
Mailing Address - Fax:
Practice Address - Street 1:438 W LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1216
Practice Address - Country:US
Practice Address - Phone:877-209-3049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032268363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health