Basic Information
Provider Information
NPI: 1548256894
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YURAS
FirstName: SHARON
MiddleName: MCNEAL
NamePrefix: MRS.
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12731 BUILDERS RD
Address2:  
City: HERNDON
State: VA
PostalCode: 201702931
CountryCode: US
TelephoneNumber: 7036890636
FaxNumber: 7034761050
Practice Location
Address1: 12330 PINECREST RD
Address2: SUITE 200
City: RESTON
State: VA
PostalCode: 201911642
CountryCode: US
TelephoneNumber: 7034761050
FaxNumber: 7034767126
Other Information
ProviderEnumerationDate: 09/22/2005
LastUpdateDate: 03/09/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X0024076395VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home