MEDICARE: LAUREN ELIZABETH TODD NP-C

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	363LP2300X	Primary Care Nurse Practitioner	0024177995	VA
2	363LG0600X	Gerontology Nurse Practitioner	0024177995	VA
3	163W00000X	Registered Nurse	0001247599	VA
4	363LA2200X	Adult Health Nurse Practitioner	0024177995	VA

General Provider Information

NPI Number	:	1205470218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELIZABETH TODD NP-C

Provider Business Mailing Address
First Line	:	445 CHARLES H DIMMOCK PKWY
Second Line	:	STE 100
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2990
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13460 TREDEGAR LAKE PKWY
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-4070
Country	:	US
Telephone Number	:	804-264-8782
Fax Number	:	804-266-9214

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

Provider Enumeration Date	:	11/01/2019
Last Update Date	:	02/25/2026

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