Healthcare Provider Details

I. General information

NPI: 1700732096
Provider Name (Legal Business Name): LARESA J MEADOWS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N GLEBE RD STE 1600
ARLINGTON VA
22201-5798
US

IV. Provider business mailing address

1100 N GLEBE RD STE 1600
ARLINGTON VA
22201-5798
US

V. Phone/Fax

Practice location:
  • Phone: 571-350-8400
  • Fax: 703-528-0338
Mailing address:
  • Phone: 571-350-8400
  • Fax: 703-528-0338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024194121
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: