Provider Demographics
NPI:1801003744
Name:SMITH, SARAH (RN, CRNA, LNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, CRNA, LNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-5820
Mailing Address - Country:US
Mailing Address - Phone:804-598-8543
Mailing Address - Fax:
Practice Address - Street 1:2440 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5820
Practice Address - Country:US
Practice Address - Phone:804-598-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024069362367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered