Provider Demographics
NPI:1790885002
Name:CELLON, SARA JEANETTE (ARNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JEANETTE
Last Name:CELLON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JEANETTE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1582 W INTRUDER CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5415
Mailing Address - Country:US
Mailing Address - Phone:352-281-4125
Mailing Address - Fax:
Practice Address - Street 1:100 BREWSTER BLVD
Practice Address - Street 2:
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547-2538
Practice Address - Country:US
Practice Address - Phone:910-449-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166746363LF0000X
FL9205510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily