MEDICARE: MS. LAURIE STEWART MEHALIC N.P.

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	363LW0102X	Women's Health Nurse Practitioner	0024164366	VA

General Provider Information

NPI Number	:	1730260266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURIE STEWART MEHALIC N.P.

Provider Business Mailing Address
First Line	:	6544 EASTERN AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2102
Country	:	US
Telephone Number	:	202-291-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 WASHINGTON BLVD FL 2
Second Line	:	COMMUNITY HEALTH SERVICES BUREAU
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	703-228-1220
Fax Number	:	703-228-1166

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	10/22/2010

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