Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 0024165247 | VA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 0024165247 | VA |
NPI | 1508818790 |
---|---|
Provider Name | Ms. Nancye Lynn Sadler |
First Address | Manassas, VA 20110-4414 |
Second Address | Manassas, VA 20110-4414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508818790 | (05) | VA |
8951641 | (05) | VA |
OTH000 | (02) | VA |
P00044670 | RAILROAD MEDICARE (01) | VA |