Provider Demographics
NPI:1871087940
Name:POWERS, DANIEL JOSEPH (FNP-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH
Last Name:POWERS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 FILLMORE AVE APT 200
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-5009
Mailing Address - Country:US
Mailing Address - Phone:615-389-4517
Mailing Address - Fax:
Practice Address - Street 1:4660 KENMORE AVE STE 600
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1314
Practice Address - Country:US
Practice Address - Phone:703-212-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily