Provider Demographics
NPI:1932744984
Name:LEDGISTER, AVA-GAY SASHA (FNP-C)
Entity type:Individual
Prefix:
First Name:AVA-GAY
Middle Name:SASHA
Last Name:LEDGISTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AVAGAY
Other - Middle Name:SASHA
Other - Last Name:LEDGISTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:20680 SENECA MEADOWS PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7029
Mailing Address - Country:US
Mailing Address - Phone:678-559-4646
Mailing Address - Fax:
Practice Address - Street 1:1715 N GEORGE MASON DR STE 107
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3642
Practice Address - Country:US
Practice Address - Phone:703-717-4738
Practice Address - Fax:703-717-4578
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16862400163WE0003X
VA0024189611363L00000X
NJ26NJ00993300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0715671Medicaid