Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0024176870 | VA |
NPI | 1174092415 |
---|---|
Provider Name | Sarah Kinnan Dearman |
First Address | Norfolk, VA 23507-1971 |
Second Address | Norfolk, VA 23507-1971 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2018 |
Last Update Date | 15/11/2018 |