Healthcare Provider Details

I. General information

NPI: 1609393891
Provider Name (Legal Business Name): SARAH D WHITEHEAD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-7000
  • Fax: 443-537-9913
Mailing address:
  • Phone: 202-877-7000
  • Fax: 443-537-9913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR244084
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: