Healthcare Provider Details

I. General information

NPI: 1346883220
Provider Name (Legal Business Name): SABRINA ANN SALEM DNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12872 HARBOR DR
WOODBRIDGE VA
22192-2921
US

IV. Provider business mailing address

12872 HARBOR DR
WOODBRIDGE VA
22192-2921
US

V. Phone/Fax

Practice location:
  • Phone: 703-454-5362
  • Fax: 703-977-1544
Mailing address:
  • Phone: 703-454-5362
  • Fax: 703-977-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024178023
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178023
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: