Provider Demographics
NPI:1972334324
Name:FLANIGAN, SARA CRISTINA (RDN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CRISTINA
Last Name:FLANIGAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 ANCIENT OAK CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2067
Mailing Address - Country:US
Mailing Address - Phone:571-242-6591
Mailing Address - Fax:
Practice Address - Street 1:4005 ANCIENT OAK CT
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2067
Practice Address - Country:US
Practice Address - Phone:571-242-6591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86011814133VN1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology