Healthcare Provider Details

I. General information

NPI: 1932744984
Provider Name (Legal Business Name): AVA-GAY SASHA LEDGISTER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AVAGAY SASHA LEDGISTER FNP-C

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N GEORGE MASON DR STE 107
ARLINGTON VA
22205-3642
US

IV. Provider business mailing address

20680 SENECA MEADOWS PKWY STE 206
GERMANTOWN MD
20876-7029
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4738
  • Fax: 703-717-4578
Mailing address:
  • Phone: 678-559-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number26NR16862400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024189611
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00993300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: