Provider Demographics
NPI:1750811469
Name:MATHERLY, SARA BETH (NP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:BETH
Last Name:MATHERLY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:8491 ASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-6628
Mailing Address - Country:US
Mailing Address - Phone:757-636-2857
Mailing Address - Fax:
Practice Address - Street 1:11848 ROCK LANDING DR STE 402
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4425
Practice Address - Country:US
Practice Address - Phone:757-873-1374
Practice Address - Fax:757-873-1612
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2019-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024174809363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology