Individual
SARAH DIANE KURSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
199 HOSPITAL DR, SUITE 5, GALAX, VA 24333-2454
(276) 236-6136
(276) 236-2536
Mailing address
55 CEDAR PT, GALAX, VA 24333-2535
(276) 236-9368
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-001123
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008901163
—
VA
05
—
010014719
—
VA
05
—
8901171
—
VA
Enumeration date
11/23/2005
Last updated
10/29/2008
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