Provider Demographics
NPI:1073985388
Name:MEEKER, DANIELLE (MPAS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MEEKER
Suffix:
Gender:F
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4375 FAIR LAKES CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-4234
Mailing Address - Country:US
Mailing Address - Phone:571-432-2600
Mailing Address - Fax:
Practice Address - Street 1:4375 FAIR LAKES CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-4234
Practice Address - Country:US
Practice Address - Phone:571-432-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6122363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant