Healthcare Provider Details

I. General information

NPI: 1508818790
Provider Name (Legal Business Name): NANCYE LYNN SADLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 DIGGES RD STE 104
MANASSAS VA
20110-4414
US

IV. Provider business mailing address

9001 DIGGES RD STE 104
MANASSAS VA
20110-4414
US

V. Phone/Fax

Practice location:
  • Phone: 703-239-3602
  • Fax: 855-888-8410
Mailing address:
  • Phone: 703-239-3602
  • Fax: 866-765-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024165247
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number0024165247
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: