Provider Demographics
NPI:1619797248
Name:MOSSBURG, SARAH (RN, PHD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:MOSSBURG
Suffix:
Gender:F
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W GEORGE MASON RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4002
Mailing Address - Country:US
Mailing Address - Phone:703-582-6856
Mailing Address - Fax:
Practice Address - Street 1:123 W GEORGE MASON RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4002
Practice Address - Country:US
Practice Address - Phone:703-582-6856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001168903163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse