Healthcare Provider Details

I. General information

NPI: 1093434425
Provider Name (Legal Business Name): LAUREN ZOECKLER MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 BROWNS WAY RD
MIDLOTHIAN VA
23114-9501
US

IV. Provider business mailing address

230 BROWNS WAY RD
MIDLOTHIAN VA
23114-9501
US

V. Phone/Fax

Practice location:
  • Phone: 804-419-9101
  • Fax:
Mailing address:
  • Phone: 804-419-9101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024190122
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5017418
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: