1306134218 NPI number — MRS. SARAH DIANE SHAVER DUNCAN RN, CCRN

Table of content: MRS. SARAH DIANE SHAVER DUNCAN RN, CCRN (NPI 1306134218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306134218 NPI number — MRS. SARAH DIANE SHAVER DUNCAN RN, CCRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNCAN
Provider First Name:
SARAH
Provider Middle Name:
DIANE SHAVER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, CCRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHAVER
Provider Other First Name:
SARAH
Provider Other Middle Name:
DIANE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306134218
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3020 HAMAKER CT., SUITE 502
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-208-7257
Provider Business Mailing Address Fax Number:
703-208-7259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3020 HAMAKER CT., SUITE 502
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-208-7257
Provider Business Practice Location Address Fax Number:
703-208-7259
Provider Enumeration Date:
07/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC0200X , with the licence number:  RN1006510 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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