Provider Demographics
NPI:1568904399
Name:LATTIMER, MICHELE LYN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LYN
Last Name:LATTIMER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 FALL HILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401
Mailing Address - Country:US
Mailing Address - Phone:540-371-9696
Mailing Address - Fax:540-899-3805
Practice Address - Street 1:2601 FALL HILL AVENUE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-371-9696
Practice Address - Fax:540-899-3805
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily