Provider Demographics
NPI:1750626677
Name:PACIULLI, SARAH CATHERINE (NP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:CATHERINE
Last Name:PACIULLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 BOULEVARD
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2323
Mailing Address - Country:US
Mailing Address - Phone:804-520-1764
Mailing Address - Fax:
Practice Address - Street 1:2801 BOULEVARD
Practice Address - Street 2:SUITE D
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2323
Practice Address - Country:US
Practice Address - Phone:804-520-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily