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NPI Code Detail

MEDICARE: MS. CLAIRE LOUISE LAURENZA MSN, APRN,BC

MEDICARE: MS. CLAIRE LOUISE LAURENZA MSN, APRN,BC
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
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse0001093793VA
2163WP0809XAdult Psychiatric/Mental Health Registered Nurse0015000179VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17070119OTHERVAAETNA NUMBER
2J3170001OTHERVACAREFIRST BC NUMBER
3059009OTHERVAANTHEM BC/BS
4255174000OTHERVAMAGELLAN NUMBER

General Provider Information

NPI Number : 1386640134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CLAIRE LOUISE LAURENZA MSN, APRN,BC
Provider Business Mailing Address
First Line : 2032 ROYAL FERN CT.
Second Line : 1-A
City : RESTON
State : VA
Zip : 20191-2032
Country : US
Telephone Number : 703-598-8402
Fax Number : 703-391-7381
Provider Business Practice Location Address
First Line : 11870 SUNRISE VALLEY DR
Second Line : STE 200
City : RESTON
State : VA
Zip : 20191-3303
Country : US
Telephone Number : 703-598-8402
Fax Number : 703-391-7381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 10/28/2019

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