Provider Demographics
NPI:1902873565
Name:LAYTON, DANIELLE ALI (PA-C, MPAS)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ALI
Last Name:LAYTON
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Gender:F
Credentials:PA-C, MPAS
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Mailing Address - Street 1:3700 JOSEPH SIEWICK DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1744
Mailing Address - Country:US
Mailing Address - Phone:703-698-8960
Mailing Address - Fax:
Practice Address - Street 1:3028 JAVIER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4622
Practice Address - Country:US
Practice Address - Phone:703-698-8960
Practice Address - Fax:703-641-8427
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC103579363AM0700X
TN1185363AM0700X
VA0110003284363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical