Healthcare Provider Details

I. General information

NPI: 1396420709
Provider Name (Legal Business Name): SARAH KATHLEEN HULL ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 WISCONSIN AVENUE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

935 GRANDIN AVE
ROCKVILLE MD
20851-1322
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-0206
  • Fax:
Mailing address:
  • Phone: 610-417-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number25232
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: