Healthcare Provider Details

I. General information

NPI: 1669102489
Provider Name (Legal Business Name): SARAH YEAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41816 FENWAY CIR
ASHBURN VA
20148-8069
US

IV. Provider business mailing address

3121 PATRICK HENRY DR APT 331
FALLS CHURCH VA
22044-2315
US

V. Phone/Fax

Practice location:
  • Phone: 703-743-3999
  • Fax:
Mailing address:
  • Phone: 484-706-2119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNP1044979
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: