Provider Demographics
NPI:1255391298
Name:SEMONES, SARAH LYNNE (RN, MS, PMHCNS, NP-C)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LYNNE
Last Name:SEMONES
Suffix:
Gender:F
Credentials:RN, MS, PMHCNS, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MELVINS END
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-2566
Mailing Address - Country:US
Mailing Address - Phone:757-846-8237
Mailing Address - Fax:
Practice Address - Street 1:103 MELVINS END
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-2566
Practice Address - Country:US
Practice Address - Phone:757-846-8237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001500463364SP0809X
VA0024168429363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1255391298Medicaid
VA1255391298OtherMEDICARE