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General NPI Number Information
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NPI Number | 1316297591
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Entity Type | Individual
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Provider Name | SARAH A BRADY NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 8640 SUDLEY RD SUITE 201
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City | MANASSAS
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State | VA
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Zip | 20110-4420
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Country | US
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Telephone | 703-368-6819
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Fax | 703-330-2923
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Provider Business Mailing Address
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Address Line | 8640 SUDLEY RD SUITE 201
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City | MANASSAS
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State | VA
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Zip | 20110-4420
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Country | US
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Telephone | 703-368-6819
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Fax | 703-330-2923
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024170364
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License Number State | VA
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