Individual provider Active NPI

Elizabeth Mbene Wainaina, FNP

  • Family Nurse Practitioner
  • Lake Ridge, VA
National Provider Identifier
1700679826
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024193165 Issued in VA
Practice address
2544 Paxton St
Lake Ridge, VA 22192-3416
Phone
(703) 350-9154
NPI assigned
May 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024193165 VA Primary

Addresses

Primary practice location

2544 Paxton St
Lake Ridge, VA 22192-3416

Mailing address

2544 Paxton St
Lake Ridge, VA 22192-3416
Phone (703) 350-9154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0024193165VAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1700679826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 PAXTON ST",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923416",
            "telephone_number": "703-350-9154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 PAXTON ST",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923416",
            "telephone_number": "703-350-9154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAINAINA",
        "first_name": "ELIZABETH",
        "middle_name": "MBENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024193165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.