Provider Demographics
NPI:1497732549
Name:RUSSELL, SARAH E (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21975
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4116
Mailing Address - Country:US
Mailing Address - Phone:540-321-4281
Mailing Address - Fax:540-321-4282
Practice Address - Street 1:541 SUNSET LN STE 301
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3979
Practice Address - Country:US
Practice Address - Phone:540-825-4557
Practice Address - Fax:540-825-4566
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170117363LF0000X, 363LF0000X
WAAP30007176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497732549Medicaid
VAVV7473COtherMEDICARE