Provider Demographics
NPI:1962614891
Name:SASNER, SUSAN (RNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SASNER
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-2815
Mailing Address - Country:US
Mailing Address - Phone:703-534-7838
Mailing Address - Fax:
Practice Address - Street 1:8300 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3822
Practice Address - Country:US
Practice Address - Phone:703-448-0885
Practice Address - Fax:703-448-0439
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166750363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024166750OtherVIRGINIA STATE LICENSE