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General NPI Number Information
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NPI Number | 1194283184
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Entity Type | Individual
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Provider Name | SANDRA CETOUTE GASSANT ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 200 N GLEBE RD STE 104
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City | ARLINGTON
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State | VA
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Zip | 22203-3755
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Country | US
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Telephone | 703-841-0703
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Fax |
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Provider Business Mailing Address
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Address Line | 14905 MCKISSON CT APT A
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City | SILVER SPRING
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State | MD
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Zip | 20906-6159
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Country | US
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Telephone | 786-348-5049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024186140
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 637148
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC002865
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License Number State | MD
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