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General NPI Number Information
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NPI Number | 1730887654
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Entity Type | Individual
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Provider Name | LAUREN NICOLE DOUGLASS MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 107 N VIRGINIA AVE STE B1
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3357
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Country | US
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Telephone | 703-532-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 NICOSH CIR UNIT 3205
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1243
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Country | US
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Telephone | 919-360-4624
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024186521
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License Number State | VA
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