1073030458 NPI number — MS. SARAH FAYE ANDERSON NURSE LPN

Table of content: MS. SARAH FAYE ANDERSON NURSE LPN (NPI 1073030458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073030458 NPI number — MS. SARAH FAYE ANDERSON NURSE LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
SARAH
Provider Middle Name:
FAYE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE LPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073030458
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 FRIEND STREET
Provider Second Line Business Mailing Address:
ELEMENT CARE INC.
Provider Business Mailing Address City Name:
LYNN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-715-6608
Provider Business Mailing Address Fax Number:
781-715-6699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 BUFFUM ST.
Provider Second Line Business Practice Location Address:
ELEMENT CARE INC.
Provider Business Practice Location Address City Name:
LYNN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-715-0040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  LN60431 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com