Basic Information
| Provider Information | |||||||||
| NPI: | 1114076411 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCNAUGHTON | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | NELSON | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3215 GREENSTONE WAY | ||||||||
| Address2: | |||||||||
| City: | OAK HILL | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201713302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032727848 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2740 PROSPERITY AVE | ||||||||
| Address2: | |||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220314307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038498191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 0024164519 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.