Provider Demographics
NPI:1801597695
Name:LATTIMORE, STEPHANIE VARANELLI (NP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:VARANELLI
Last Name:LATTIMORE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4835
Mailing Address - Country:US
Mailing Address - Phone:203-558-9000
Mailing Address - Fax:
Practice Address - Street 1:WEIGHT LOSS AND VITALITY
Practice Address - Street 2:1800 K ST NW, FRONT 100
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-991-2000
Practice Address - Fax:571-367-5005
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR239220363LF0000X
DCNP1049160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily