Provider Demographics
NPI:1093766214
Name:PEPPARD, LORA E (PHD, DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:E
Last Name:PEPPARD
Suffix:
Gender:F
Credentials:PHD, DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 UNIVERSITY DRIVE, MS 3C4
Mailing Address - Street 2:GEORGE MASON UNIVERSITY
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-993-5154
Mailing Address - Fax:
Practice Address - Street 1:2807 N GLEBE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-4224
Practice Address - Country:US
Practice Address - Phone:703-284-1610
Practice Address - Fax:703-284-3816
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168567363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health