Healthcare Provider Details

I. General information

NPI: 1447238555
Provider Name (Legal Business Name): SARAH W COLEMAN C.N.P., M.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH C WILSON

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 TOWN CENTER DRIVE, SUITE 140
RESTON VA
20190-5898
US

IV. Provider business mailing address

1860 TOWN CENTER DR STE 140
RESTON VA
20190-5898
US

V. Phone/Fax

Practice location:
  • Phone: 703-437-0001
  • Fax: 703-787-5739
Mailing address:
  • Phone: 703-437-0001
  • Fax: 703-787-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024181278
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: