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General NPI Number Information
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NPI Number | 1396788600
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Entity Type | Individual
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Provider Name | LAUREN HEATHER METH PAC MPH
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 7617 LITTLE RIVER TURNPIKE #600
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-256-5680
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Fax | 703-658-1684
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Provider Business Mailing Address
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Address Line | 7617 LITTLE RIVER TPKE STE 600
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City | ANNANDALE
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State | VA
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Zip | 22003-2603
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Country | US
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Telephone | 703-256-5680
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Fax | 703-658-1684
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110001535
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License Number State | VA
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