Provider Demographics
NPI:1730794090
Name:GRUBER, SARAH-JANE (FNP)
Entity type:Individual
Prefix:
First Name:SARAH-JANE
Middle Name:
Last Name:GRUBER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17752 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:ROUND HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20141-2193
Mailing Address - Country:US
Mailing Address - Phone:571-242-9794
Mailing Address - Fax:
Practice Address - Street 1:110 EDDS LANE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-2016
Practice Address - Country:US
Practice Address - Phone:703-444-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAF09200240363LF0000X
VA0024180334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily