Provider Demographics
NPI:1346129624
Name:PERRY, SARAH NOELANI (CRNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NOELANI
Last Name:PERRY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12658 CHEYENNE LN
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-4509
Mailing Address - Country:US
Mailing Address - Phone:703-943-0787
Mailing Address - Fax:
Practice Address - Street 1:22738 MAPLE RD STE 120
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3347
Practice Address - Country:US
Practice Address - Phone:240-794-3008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily