Doctor Name: | MRS. STACEY NICOLE LAMBOUR |
NPI Number: | 1386059988 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PMHNP-BC |
License Number: | 0024171782 |
Business Practice Address: | 43130 Amberwood Plz 140 South Riding, VA - 201524105 |
Business Phone Number: | 7033480030 |
Business Fax Number: | |
Mailing Address: | 43130 Amberwood Plz, 140 SOUTH RIDING |
State: | VA |
Postal Code: | 201524105 |
Phone Number: | 7033480030 |
Fax Number: | |
NPI Enumeration Date: | 06/23/2014 |
NPI Last Update Date: | 07/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 0024171782 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |