Provider Demographics
NPI:1780219766
Name:WHITEHEAD, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WHITEHEAD
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 1:114 NANCY DR APT 1308N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4863
Mailing Address - Country:US
Mailing Address - Phone:757-367-4934
Mailing Address - Fax:
Practice Address - Street 1:114 NANCY DR APT 1308N
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4863
Practice Address - Country:US
Practice Address - Phone:757-367-4934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide