Provider Demographics
NPI:1205887486
Name:SPEAKES, DONNA MICHELE HUFF (PA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MICHELE HUFF
Last Name:SPEAKES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11716 AMKIN DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-2121
Mailing Address - Country:US
Mailing Address - Phone:703-825-1111
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:44045 RIVERSIDE PKWY
Practice Address - Street 2:LOUDOUN HOSPITAL CENTER
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5101
Practice Address - Country:US
Practice Address - Phone:703-858-6044
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001580363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP79743Medicare UPIN
VA017491B00Medicare ID - Type Unspecified