Healthcare Provider Details

I. General information

NPI: 1255927638
Provider Name (Legal Business Name): SARAH A YANKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date: 02/18/2026
Reactivation Date: 02/24/2026

III. Provider practice location address

7220 FAIRCHILD DR
ALEXANDRIA VA
22306-7220
US

IV. Provider business mailing address

7220 FAIRCHILD DR
ALEXANDRIA VA
22306-7220
US

V. Phone/Fax

Practice location:
  • Phone: 571-473-2054
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011648
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: