Healthcare Provider Details

I. General information

NPI: 1184380008
Provider Name (Legal Business Name): SARA ANNE RIEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 STONEY RIDGE RD
CHARLOTTESVILLE VA
22902-8703
US

IV. Provider business mailing address

4 CLARK CT
PALMYRA VA
22963-3227
US

V. Phone/Fax

Practice location:
  • Phone: 540-810-1143
  • Fax:
Mailing address:
  • Phone: 540-810-1143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number0024188573
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001251327
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: