Provider Demographics
NPI:1265493084
Name:NAUGHTON, LAUREN FELICIA (PA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:FELICIA
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 FAIRFAX DR
Mailing Address - Street 2:SUITE #200
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1772
Mailing Address - Country:US
Mailing Address - Phone:703-525-8863
Mailing Address - Fax:
Practice Address - Street 1:3022 WILLIAMS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4600
Practice Address - Country:US
Practice Address - Phone:703-573-9800
Practice Address - Fax:703-573-2959
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001924363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0110001924OtherSTATE LIC #
VA822999OtherGROUP MEDICARE #
VAQ30479Medicare UPIN
VA015308A99Medicare ID - Type Unspecified