Healthcare Provider Details

I. General information

NPI: 1497574172
Provider Name (Legal Business Name): ANDREA LANE VANMETER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 SUNRISE BLVD
ROMNEY WV
26757-4607
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 320
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-4932
  • Fax: 304-822-4957
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number120646
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: