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General NPI Number Information
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NPI Number | 1528311941
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Entity Type | Individual
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Provider Name | LYNN ANN VANAIRSDALE DO, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3259 CATLIN AVE
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City | QUANTICO
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State | VA
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Zip | 22134-5109
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Country | US
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Telephone | 703-784-1725
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Fax |
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Provider Business Mailing Address
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Address Line | 252 DAHLIA AVE
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-1906
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Country | US
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Telephone | 608-215-8213
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 0102205768
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 554-55
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License Number State | WI
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