Individual
LAUREN CASSIS JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
98 ALEXANDRIA PIKE,, SUITE 52, WARRENTON, VA 20186
(540) 905-7456
Mailing address
98 ALEXANDRIA PIKE,, SUITE 52, WARRENTON, VA 20186
(540) 905-7456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003420
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205135159
—
VA
Enumeration date
03/17/2011
Last updated
10/25/2022
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