Provider Demographics
NPI:1730260266
Name:MEHALIC, LAURIE STEWART (NP)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:STEWART
Last Name:MEHALIC
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:6544 EASTERN AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2102
Mailing Address - Country:US
Mailing Address - Phone:202-291-3733
Mailing Address - Fax:
Practice Address - Street 1:2100 WASHINGTON BLVD FL 2
Practice Address - Street 2:COMMUNITY HEALTH SERVICES BUREAU
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5703
Practice Address - Country:US
Practice Address - Phone:703-228-1220
Practice Address - Fax:703-228-1166
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024164366363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health