Healthcare Provider Details

I. General information

NPI: 1598188039
Provider Name (Legal Business Name): LORRAINE HEGI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORRAINE GRIFFIN

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 FALL HILL AVE SUITE 515
FREDERICKSBURG VA
22401-3342
US

IV. Provider business mailing address

2300 FALL HILL AVE SUITE 515
FREDERICKSBURG VA
22401-3342
US

V. Phone/Fax

Practice location:
  • Phone: 540-741-3260
  • Fax: 540-741-3261
Mailing address:
  • Phone: 540-741-3260
  • Fax: 540-741-3261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024169807
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: