SANDRA CUSTODIO

CHARLOTTESVILLE, VA
NPI1669886396
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: VA  0024189672)
Additional Taxonomies207RI0200X Internal Medicine, Infectious Disease
(Licence: VA  0024189672)
363LA2200X Nurse Practitioner, Adult Health
(Licence: MA  RN2328892)
163W00000X Registered Nurse
(Licence: MA  RN2328892)
Enumeration Date2014-06-20
Last Update Date2025-01-24
Business Address
SANDRA CUSTODIO AG-PCNP
415 RAY C HUNT DR STE 2200
CHARLOTTESVILLE, VA 22903-2980
Phone number: 434-924-5700
Mailing Address
SANDRA CUSTODIO AG-PCNP
PO BOX 749112
ATLANTA, GA 30374-9112
Phone number: 434-295-1000