Healthcare Provider Details

I. General information

NPI: 1487353108
Provider Name (Legal Business Name): LAUREN WOOD HOUSE NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN BRYAN WOOD NNP-BC

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 06/16/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1971
US

IV. Provider business mailing address

601 CHILDRENS LN
NORFOLK VA
23507-1971
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7452
  • Fax:
Mailing address:
  • Phone: 757-668-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number0024186639
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: