Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 2017011998 | VA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 2017011998 | VA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 2017011998 | VA |
NPI | 1083124325 |
---|---|
Provider Name | Lu Lucy Wei |
First Address | Fairfax, VA 22031-4340 |
Second Address | Fairfax, VA 22031-4340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2017 |
Last Update Date | 30/09/2017 |