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General NPI Number Information
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NPI Number | 1225920838
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Entity Type | Individual
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Provider Name | HANNAH LARK CPNP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 14535 JOHN MARSHALL HWY STE 201
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City | GAINESVILLE
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State | VA
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Zip | 20155-4024
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Country | US
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Telephone | 703-753-6184
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Fax |
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Provider Business Mailing Address
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Address Line | 4228 PENNSBORO CT
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City | CHANTILLY
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State | VA
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Zip | 20151-2726
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Country | US
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Telephone | 703-927-6389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 0024194081
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License Number State | VA
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