Provider Demographics
NPI:1124127253
Name:CAYOU, TAMMY DEAN (CPNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:DEAN
Last Name:CAYOU
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:MARIE
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:19450 DEERFIELD AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-723-7337
Mailing Address - Fax:703-723-6848
Practice Address - Street 1:19450 DEERFIELD AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-723-7337
Practice Address - Fax:703-723-6848
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0003810-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010320372Medicaid
VA010321221Medicaid
VAC06319Medicare PIN