Provider Demographics
NPI:1407106826
Name:DAYTON, AMANDA B (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:DAYTON
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 1:552 FORT EVANS RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3378
Mailing Address - Country:US
Mailing Address - Phone:703-737-0197
Mailing Address - Fax:
Practice Address - Street 1:552 FORT EVANS RD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3378
Practice Address - Country:US
Practice Address - Phone:703-737-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170134363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health