Provider Demographics
NPI:1982160891
Name:TOTH, BLAINE SARAH (CRNP)
Entity Type:Individual
Prefix:
First Name:BLAINE
Middle Name:SARAH
Last Name:TOTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BLAINE
Other - Middle Name:SARAH
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:43750 LEES MILL SQ
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3821
Mailing Address - Country:US
Mailing Address - Phone:301-366-3299
Mailing Address - Fax:
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1422
Practice Address - Country:US
Practice Address - Phone:301-896-3202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily