Provider Demographics
NPI:1992719694
Name:STRICKLAND, METINEE SARASUP (PA)
Entity type:Individual
Prefix:MRS
First Name:METINEE
Middle Name:SARASUP
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 ARMY PENTAGON CORRIDOR 8, ROOM 110
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20310-0001
Mailing Address - Country:US
Mailing Address - Phone:703-692-8849
Mailing Address - Fax:703-692-6250
Practice Address - Street 1:5801 ARMY PENTAGON CORRIDOR 8, ROOM 110
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-2040
Practice Address - Country:US
Practice Address - Phone:703-692-8849
Practice Address - Fax:703-692-6250
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001410363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ52515Medicare UPIN