Provider Demographics
NPI:1033680871
Name:ANDERSON, SARAH BETH (CPM, LM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:BETH
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPM, LM
Mailing Address - Street 1:633 LA MAISON RD
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-3601
Mailing Address - Country:US
Mailing Address - Phone:337-852-8968
Mailing Address - Fax:
Practice Address - Street 1:633 LA MAISON RD
Practice Address - Street 2:
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529-3601
Practice Address - Country:US
Practice Address - Phone:337-852-8968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA311071176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife