Laura Lisbeth Kennedy, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024173863 Issued in VA

Practice address

12040 S Lakes Dr
Reston, VA 20191-1246

Phone

(703) 464-0686

NPI assigned

Aug 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Laura Ida Lisbeth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: laura.lisbeth@105592283987972.direct.elationemr.com

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

{
    "created_epoch": "1472256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1760938161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 S LAKES DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911246",
            "telephone_number": "703-464-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 S LAKES DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911246",
            "telephone_number": "703-464-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LAURA",
        "middle_name": "LISBETH",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-27",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001232629",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "LISBETH",
            "middle_name": "IDA",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Loza Kelly, PA-C
• Lawrence F.X. Kelly, M.D.
• Rachel Elizabeth Kelly
• Kelsey Wilson PLLC (Heala Psychotherapy)
• Kemet Health One LLC
• William Powell Kennedy, M.D.
• Susan Marie Kenney, RNFA
• Amanda Grace Kephart
• Aneta Kern, PH.D.
• April Rose Kern, D,M.D.

• Family Nurse Practitioner in Reston, VA
• Providers in Reston, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.