Provider Demographics
NPI:1710145339
Name:AMHAYES FLOYD, MARSABETH (FAMILY NP)
Entity Type:Individual
Prefix:MRS
First Name:MARSABETH
Middle Name:
Last Name:AMHAYES FLOYD
Suffix:
Gender:F
Credentials:FAMILY NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 ELDEN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5572
Mailing Address - Country:US
Mailing Address - Phone:240-687-4654
Mailing Address - Fax:
Practice Address - Street 1:1141 ELDEN STREET
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3128
Practice Address - Country:US
Practice Address - Phone:240-687-4654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001207430163W00000X
VA0024173346363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse