Most Relevant Information
Provider Data
| NPI Number: | 1003681461 |
| Provider Name: | CALVIN LAYNE PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 0024188311 |
Most Important Dates
| Enumeration Date: | 11/16/2023 |
| Last Updated: | 02/05/2024 |
Provider Practice Location
10304 EATON PL STE 100
FAIRFAX
VA
220302221
Practice Location Phone/Fax
| Phone: | 5714638620 |
| Fax: | 5719997549 |
Provider Mailing Location
10304 EATON PL STE 100
FAIRFAX
VA
220302221
Provider Mailing Phone/Fax
| Phone: | 5714638620 |
| Fax: | 5719997549 |