Individual
SARAH SOROOSH VANDERGOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19485 OLD JETTON RD STE 100, CORNELIUS, NC 28031-6583
(704) 384-1775
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(844) 266-8268
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011537
NC
Other
Enumeration date
01/30/2019
Last updated
10/26/2020
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