Provider Demographics
NPI:1245919828
Name:SEARLS, LILLIAN (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:SEARLS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:
Other - Last Name:FACKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3736 WINTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-9235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3736 WINTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-9235
Practice Address - Country:US
Practice Address - Phone:804-460-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2024-06-13
Deactivation Date:2023-11-15
Deactivation Code:
Reactivation Date:2023-11-22
Provider Licenses
StateLicense IDTaxonomies
VA2023032412363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care