Healthcare Provider Details

I. General information

NPI: 1538537196
Provider Name (Legal Business Name): SARAH KITTREDGE BROWN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41816 FENWAY CIR
ASHBURN VA
20148-8069
US

IV. Provider business mailing address

9640 BURKE LAKE RD
BURKE VA
22015-3022
US

V. Phone/Fax

Practice location:
  • Phone: 347-761-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172896
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: