Provider Demographics
NPI:1093311888
Name:GIBSON, SARAH COLEMAN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:COLEMAN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-1047
Mailing Address - Country:US
Mailing Address - Phone:540-910-1176
Mailing Address - Fax:
Practice Address - Street 1:1380 LITTLE SORRELL DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-7372
Practice Address - Country:US
Practice Address - Phone:540-433-4913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily