Healthcare Provider Details

I. General information

NPI: 1912799735
Provider Name (Legal Business Name): SARAH MARIE OWEN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 ROSE HILL DR
CHARLOTTESVILLE VA
22903-5128
US

IV. Provider business mailing address

626 WATSON AVE
CHARLOTTESVILLE VA
22901-3931
US

V. Phone/Fax

Practice location:
  • Phone: 434-972-6200
  • Fax:
Mailing address:
  • Phone: 234-575-5066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001245842
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024193233
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: