Provider Demographics
NPI:1700376837
Name:EVES, SARAH AUDREY PERRY
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:AUDREY PERRY
Last Name:EVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 ELECTRIC RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8449
Mailing Address - Country:US
Mailing Address - Phone:540-772-8670
Mailing Address - Fax:
Practice Address - Street 1:4035 ELECTRIC RD STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8449
Practice Address - Country:US
Practice Address - Phone:540-772-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
VA0110006293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1282880500OtherDOD ID