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General NPI Number Information
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NPI Number | 1508184912
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Entity Type | Individual
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Provider Name | SARAH REBECCA DAMEN NP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 825 FAIRFAX AVE SUITE 310
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City | NORFOLK
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State | VA
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Zip | 23507-1914
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Country | US
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Telephone | 757-446-7900
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Fax | 757-446-7464
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Provider Business Mailing Address
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Address Line | PO BOX 936 EVMS MEDICAL GROUP
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City | NORFOLK
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State | VA
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Zip | 23501-0936
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Country | US
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Telephone | 757-446-7900
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Fax | 757-446-7464
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 149715
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024170351
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License Number State | VA
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