Provider Demographics
NPI:1861454555
Name:SAGE, JANE G (NP, RN, MSN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:G
Last Name:SAGE
Suffix:
Gender:F
Credentials:NP, RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:LAUREL FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24352-0009
Mailing Address - Country:US
Mailing Address - Phone:276-398-2292
Mailing Address - Fax:276-398-3331
Practice Address - Street 1:6436 TROUTDALE HWY
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:VA
Practice Address - Zip Code:24378-2023
Practice Address - Country:US
Practice Address - Phone:866-942-0401
Practice Address - Fax:276-398-3331
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001185255163W00000X
VA0024166932363L00000X, 363LF0000X
NC5011292363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA002354166932OtherNP LICENSE
NC5010297OtherLICENSE
VA1033464060Medicaid
VA1033464060Medicaid