Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 0024173251 | VA |
NPI | 1033577390 |
---|---|
Provider Name | Sarah Vitaletti |
First Address | Stafford, VA 22554-7821 |
Second Address | Fredericksburg, VA 22401-4467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2016 |
Last Update Date | 02/02/2016 |