Provider Demographics
NPI:1740655570
Name:WALTON, SARAH H (FNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:H
Last Name:WALTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:575 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-4146
Practice Address - Country:US
Practice Address - Phone:540-967-2011
Practice Address - Fax:540-967-2982
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1740655570Medicaid