LOVERLY GLAZE SANTOS PELAYO


Address: 3289 Woodburn Rd Ste 320, Annandale, VA 22003-7354
Phone: 5713081830

LOVERLY GLAZE SANTOS PELAYO (NPI# 1508337403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508337403
Entity Type Individual
Full Name LOVERLY GLAZE SANTOS PELAYO
Practice Address 3289 Woodburn Rd Ste 320
Annandale
VA 22003-7354
Practice Telephone 5713081830
Practice Fax Number 5713081843
Mailing Telephone 5713081830
Mailing Fax Number 5713081843
Enumeration Date 2018-12-17
Last Update Date 2018-12-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
0017145514 VA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
VA NURSE PRACTITIONER LICENSE 0017145514 01

Office Location

Street Address 3289 WOODBURN RD STE 320
City ANNANDALE
State VA
Zip Code 22003-7354

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699733808 Chad Andrew Hamilton Obstetrics & Gynecology 3289 Woodburn Rd Ste 320, Annandale, VA 22003 2006-05-04

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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1174158539 Monica Kristine Thompson Nurse Practitioner 6340 Miller Dr, Alexandria, VA 22315-3512 2020-03-05
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Competitor

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City ANNANDALE
Zip Code 22003

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Dataset Information

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.

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