Individual
SANDY J UMSTOTT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1850 TOWN CENTER PKWY, RESTON HOSPITAL CENTER, RESTON, VA 20190-3219
(703) 471-0919
(703) 742-9081
Mailing address
PO BOX 2757, RESTON, VA 20195-0757
(703) 471-0919
(703) 742-9081
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024053360
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00027759
RAILROAD MEDICARE
—
Enumeration date
01/03/2006
Last updated
07/08/2007
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