The Physician & Midwife Collaborative Practice PC

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

0024169729 Issued in VA

Legal business name

THE PHYSICIAN & MIDWIFE COLLABORATIVE PRACTICE PC

Practice address

4660 Kenmore Ave
Alexandria, VA 22304-1313

Phone

(703) 370-4300

Fax

(703) 370-0044

NPI assigned

Dec 1, 2008

Last updated

Jan 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Juliann Lazzaro, CNM

Title

Certified Nurse Midwife

Phone

(716) 912-2945

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1710132972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-370-4300",
            "fax_number": "703-370-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-370-4300",
            "fax_number": "703-370-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHYSICIAN & MIDWIFE COLLABORATIVE PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "LAZZARO",
        "authorized_official_first_name": "JULIANN",
        "authorized_official_title_or_position": "CERTIFIED NURSE MIDWIFE",
        "authorized_official_telephone_number": "716-912-2945",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNM"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "VA",
            "license": "0024169729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Nurse Practitioner in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.