Healthcare Provider Details

I. General information

NPI: 1780391177
Provider Name (Legal Business Name): LAUREN FERRITER FNTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8613 CUSHMAN PL
ALEXANDRIA VA
22308-2517
US

IV. Provider business mailing address

8613 CUSHMAN PL
ALEXANDRIA VA
22308-2517
US

V. Phone/Fax

Practice location:
  • Phone: 706-392-0097
  • Fax:
Mailing address:
  • Phone: 706-392-0097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: