Healthcare Provider Details

I. General information

NPI: 1568374254
Provider Name (Legal Business Name): SEAN MATTHEW LAMPHIER FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12581 MILSTEAD WAY STE 103
WOODBRIDGE VA
22192-5446
US

IV. Provider business mailing address

368 S PICKETT STREET #22459
ALEXANDRIA VA
22304
US

V. Phone/Fax

Practice location:
  • Phone: 703-897-5890
  • Fax:
Mailing address:
  • Phone: 941-249-1930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024198873
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: