Individual provider · NPI-1

Lauren Marie Fackler

Physician Assistant · Staunton, VA

NPI number1730733429
StatusActive
Last updated in NPPESJul 30, 2019

Details

NPI
1730733429
Entity type
Individual (NPI-1)
Name
Lauren Marie Fackler
Sex
Female
Sole proprietor
No
Enumeration date
Jul 30, 2019
Last updated
Jul 30, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant0110-006810VAYes

Practice location

25 Myers Corner Dr
Staunton, VA 24401-6342

Phone 540-688-2646

Mailing address

1060 Shenandoah St Apt A
Harrisonburg, VA 22802-5447

Phone 540-391-1091

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