Provider Demographics
NPI:1972856862
Name:DIDIO, SARA T (CPNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:T
Last Name:DIDIO
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 ROBIOUS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-5605
Mailing Address - Country:US
Mailing Address - Phone:804-379-9494
Mailing Address - Fax:804-379-3702
Practice Address - Street 1:11601 ROBIOUS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-5605
Practice Address - Country:US
Practice Address - Phone:804-379-9494
Practice Address - Fax:804-379-3702
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017001283363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics