MISS LUCRISHA M BANFORD (NPI# 1497888697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497888697 |
| Entity Type | Individual |
| Full Name | MISS LUCRISHA M BANFORD |
| Credential | PA |
| Practice Address |
3700 Joseph Siewick Dr Suite 403 Fairfax VA 22033-1744 |
| Practice Telephone | 7036482488 |
| Practice Fax Number | 7036482489 |
| Mailing Telephone | 7036482488 |
| Mailing Fax Number | 7036482489 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110002011 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | NPI | 1497888697 | 01 |
| Street Address |
3700 JOSEPH SIEWICK DR SUITE 403 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-1744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740288315 | Marietta F Grundlehner | Specialist | 3700 Joseph Siewick Dr, #305, Fairfax, VA 22033-1744 | 2005-07-08 |
| 1720640790 | Samon Nazemian | Clinic/Center | 3700 Joseph Siewick Dr, Fairfax, VA 22033-1744 | 2019-07-01 |
| 1780112961 | Sylvie C Gatcham Tieuzu'u | Specialist/Technologist, Other | 3700 Joseph Siewick Dr, Fairfax, VA 22033-1744 | 2017-06-01 |
| 1215311592 | Stacey Michelle Akers | Nurse Practitioner | 3700 Joseph Siewick Dr, Suite 300, Fairfax, VA 22033-1744 | 2015-07-16 |
| 1851784714 | Waheedullah Ahmadi | Specialist/Technologist, Other | 3700 Joseph Siewick Dr, 408, Fairfax, VA 22033-1744 | 2015-03-16 |
| 1063816155 | Nova Wound Care, P.C. | Family Medicine | 3700 Joseph Siewick Dr, 303, Fairfax, VA 22033-1744 | 2014-10-17 |
| 1144523218 | Shohreh Sharif | Dentist | 3700 Joseph Siewick Dr, Suite 104, Fairfax, VA 22033-1744 | 2010-12-13 |
| 1003126285 | Kristin Dermody Maggi | Physician Assistant | 3700 Joseph Siewick Dr, Suite 308, Fairfax, VA 22033-1744 | 2010-10-20 |
| 1821305079 | Morgan Elizabeth Klein | Physician Assistant | 3700 Joseph Siewick Dr, Ste 404, Fairfax, VA 22033-1744 | 2010-09-09 |
| 1568781706 | Ivan Peter Harnden | Internal Medicine | 3700 Joseph Siewick Dr, Suite 308, Fairfax, VA 22033-1744 | 2010-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396366555 | Sheelon Aghili | Physician Assistant | 5801 Hampton Forest Way, Fairfax, VA 22030-7254 | 2020-04-29 |
| 1114327087 | Bach-duong Dinh | Physician Assistant | 8316 Arlington Blvd Ste 401, Fairfax, VA 22031-5216 | 2014-08-28 |
| 1760633283 | Xyz Clinic | Physician Assistant | 17000 Breeze Lane, Fairfax, VA 22033 | 2008-10-02 |
| 1184810574 | Elizabeth Colella Johnson | Physician Assistant | 3022 Williams Dr #300, Fairfax, VA 22031 | 2007-09-19 |
| 1548322159 | Tsion Tewolde | Physician Assistant | 3600 Joseph Siewick, Drivefair Oaks Hospitalist Group, Fairfax, VA 22033 | 2006-12-14 |
| 1841307956 | Danielle M Landzinski | Physician Assistant | 10615 Judicial Dr Ste 401, Fairfax, VA 22030-7501 | 2006-08-24 |
| 1902873565 | Danielle Ali Layton | Physician Assistant | 3028 Javier Rd, Suite 300, Fairfax, VA 22031-4622 | 2006-03-02 |
| 1215437413 | Caitlin Noelle Fortune | Physician Assistant | 3700 Joseph Siewick Dr Ste 308, Fairfax, VA 22033-1739 | 2018-02-15 |
| 1396270310 | Jessica Nicole Ortega | Physician Assistant | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2017-04-27 |
| 1295116952 | Faith Saunders | Physician Assistant | 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709 | 2015-06-17 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.