Healthcare Provider Details

I. General information

NPI: 1811437049
Provider Name (Legal Business Name): SARAH MONAHAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17620 MARYMERE CT
MOSELEY VA
23120-1857
US

IV. Provider business mailing address

17620 MARYMERE CT
MOSELEY VA
23120-1857
US

V. Phone/Fax

Practice location:
  • Phone: 941-323-5574
  • Fax:
Mailing address:
  • Phone: 941-323-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024186735
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: