MEDICARE: OLGUERLINE LAMOUSNERY MSN,FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	0001214562	VA
2	363LF0000X	Family Nurse Practitioner	0024177654	VA
3	207Q00000X	Family Medicine Physician	0024177654	VA

General Provider Information

NPI Number	:	1356756068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGUERLINE LAMOUSNERY MSN,FNP-BC

Provider Business Mailing Address
First Line	:	14087 RICHMOND HWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-2171
Country	:	US
Telephone Number	:	571-300-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	14087 RICHMOND HWY STE 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-2171
Country	:	US
Telephone Number	:	571-300-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	01/21/2025

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