Evernorth Care Providers - Tennessee PC
Evernorth Care Providers - Tennessee PC is a General Practice Physician in Fairfax, Virginia. Registered with an NPI since 2023.
- In the registry since
- 2023
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
11350 Random Hills Rd Ste 800Fairfax, VA 22030-6044
Phone: (773) 292-4800
Fax: (312) 564-4059
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X |
|---|
Record details
| NPI number | 1174304976 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jacqueline Lakes — Senior Paralegal · (954) 446-0640 |
| NPI enumerated | October 9, 2023 |
| Last updated in NPPES | July 14, 2025 |
| Certification date | July 14, 2025 |
| Mailing address | 730 Cool Springs Blvd Ste 500, Franklin, TN 37067-7331 |
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