Provider Demographics
NPI:1477165553
Name:WADHAMS, SARAH BRECKINRIDGE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BRECKINRIDGE
Last Name:WADHAMS
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 1:1453 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-7758
Mailing Address - Country:US
Mailing Address - Phone:303-960-8821
Mailing Address - Fax:
Practice Address - Street 1:3485 W 5200 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9438
Practice Address - Country:US
Practice Address - Phone:801-475-3900
Practice Address - Fax:801-475-3901
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12846750-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner