Provider Demographics
NPI:1346722717
Name:KEEFER, SARA ELIZABETH KONOPKA (CPNP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELIZABETH KONOPKA
Last Name:KEEFER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-1715
Mailing Address - Country:US
Mailing Address - Phone:717-357-1783
Mailing Address - Fax:
Practice Address - Street 1:6565 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3013
Practice Address - Country:US
Practice Address - Phone:703-534-1000
Practice Address - Fax:703-536-7763
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176570363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics