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NPI Code Detail

MEDICARE: LO M LUMSDEN ANP, EDD

MEDICARE: LO M LUMSDEN ANP, EDD
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
1363LF0000XFamily Nurse Practitioner0001055783VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001055783OTHERVALIC

General Provider Information

NPI Number : 1508865874
Entity Type Code : Individual
Provider Name (Legal Business Name) : LO M LUMSDEN ANP, EDD
Provider Business Mailing Address
First Line : 860 OMNI BLVD STE 101
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-4430
Country : US
Telephone Number : 757-232-8769
Fax Number : 757-232-8875
Provider Business Practice Location Address
First Line : 816 INDEPENDENCE BLVD STE 3L
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-6010
Country : US
Telephone Number : 757-751-7421
Fax Number : 757-937-5970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 03/07/2023

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Directions to “ LO M LUMSDEN ANP, EDD” Practice Location

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