Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024176007 | VA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 0024176007 | VA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 0024176007 | VA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0024176007 | VA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 0024176007 | VA |
NPI | 1023502341 |
---|---|
Provider Name | Mrs. Lauren Elizabeth Moyles |
First Address | Fredericksburg, VA 22402-3339 |
Second Address | Fredericksburg, VA 22401-4490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2018 |
Last Update Date | 03/10/2018 |