Healthcare Provider Details

I. General information

NPI: 1518084086
Provider Name (Legal Business Name): PATRICIA GRESHAM LEIGHTON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6196 ARLINGTON BLVD
FALLS CHURCH VA
22044
US

IV. Provider business mailing address

8230 BOONE BLVD
VIENNA VA
22182-2621
US

V. Phone/Fax

Practice location:
  • Phone: 703-237-3446
  • Fax: 703-237-9355
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024100278
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: