Provider Demographics
NPI:1396788600
Name:METH, LAUREN HEATHER (PAC MPH)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:HEATHER
Last Name:METH
Suffix:
Gender:F
Credentials:PAC MPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7617 LITTLE RIVER TPKE STE 600
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2603
Mailing Address - Country:US
Mailing Address - Phone:703-256-5680
Mailing Address - Fax:703-658-1684
Practice Address - Street 1:7617 LITTLE RIVER TURNPIKE
Practice Address - Street 2:#600
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-256-5680
Practice Address - Fax:703-658-1684
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001535363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P93529Medicare UPIN
VA012236C28Medicare ID - Type Unspecified