Provider Demographics
NPI:1639539505
Name:HEIN, DANIELLE ABOU (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ABOU
Last Name:HEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ABOU
Other - Last Name:YAGHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:2450 BUTLER ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-5303
Practice Address - Country:US
Practice Address - Phone:610-991-3136
Practice Address - Fax:610-991-3137
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058077363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA547171YUNMMedicare PIN
PA547171YEBKMedicare PIN