Provider Demographics
NPI:1790203586
Name:GRAWE, SARA ELISE HERBST (MSN, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELISE HERBST
Last Name:GRAWE
Suffix:
Gender:F
Credentials:MSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1007
Mailing Address - Country:US
Mailing Address - Phone:703-507-1974
Mailing Address - Fax:
Practice Address - Street 1:5721 5TH ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1007
Practice Address - Country:US
Practice Address - Phone:703-507-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-42203163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant