Basic Information
| Provider Information | |||||||||
| NPI: | 1265493084 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAUGHTON | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | FELICIA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3833 FAIRFAX DR | ||||||||
| Address2: | SUITE #200 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222031772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035258863 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3022 WILLIAMS DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220314600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7035739800 | ||||||||
| FaxNumber: | 7035732959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 03/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 0110001924 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 0110001924 | 01 | VA | STATE LIC # | OTHER | 822999 | 01 | VA | GROUP MEDICARE # | OTHER |