1396788600 NPI number — MRS. LAUREN HEATHER METH PAC MPH

Table of content: MRS. LAUREN HEATHER METH PAC MPH (NPI 1396788600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396788600 NPI number — MRS. LAUREN HEATHER METH PAC MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
METH
Provider First Name:
LAUREN
Provider Middle Name:
HEATHER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PAC MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396788600
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7617 LITTLE RIVER TPKE STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNANDALE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22003-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-256-5680
Provider Business Mailing Address Fax Number:
703-658-1684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7617 LITTLE RIVER TURNPIKE
Provider Second Line Business Practice Location Address:
#600
Provider Business Practice Location Address City Name:
ANNANDALE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-256-5680
Provider Business Practice Location Address Fax Number:
703-658-1684
Provider Enumeration Date:
06/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  0110001535 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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