Provider Demographics
NPI:1669568440
Name:LAMB, ELIZABETH MYERS (NP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MYERS
Last Name:LAMB
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 ATHERHOLT RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2148
Mailing Address - Country:US
Mailing Address - Phone:434-200-5252
Mailing Address - Fax:434-847-3645
Practice Address - Street 1:2410 ATHERHOLT ROAD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:434-200-5252
Practice Address - Fax:434-847-3645
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167066363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010336252Medicaid
VAQ77612Medicare UPIN