MEDICARE: MRS. SARA COVALL NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024172002	VA
2	363LF0000X	Family Nurse Practitioner	AC005384	MD

General Provider Information

NPI Number	:	1922408970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA COVALL NP-C

Provider Business Mailing Address
First Line	:	5220 CONCORDIA ST
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-3408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4701 SANGAMORE RD STE S207
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20816-2529
Country	:	US
Telephone Number	:	202-684-7167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2014
Last Update Date	:	05/22/2023

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