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Individual

LAURA FAEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
8081 INNOVATION PARK DR, FAIRFAX, VA 22031-4867
(571) 472-4724
(571) 472-1601
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
651820
NY
363LF0000X
Family Nurse Practitioner
Primary
0024180551
VA
363LF0000X
Family Nurse Practitioner
2017010551
NY
363LF0000X
Family Nurse Practitioner
341996-1
NY

Other

Enumeration date
01/20/2016
Last updated
03/19/2021
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