Provider Demographics
NPI:1366911448
Name:BUSTAMANTE, SARAH CATHERINE (BA, C-IAYT, SBD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHERINE
Last Name:BUSTAMANTE
Suffix:
Gender:F
Credentials:BA, C-IAYT, SBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 NW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-3217
Mailing Address - Country:US
Mailing Address - Phone:405-788-7348
Mailing Address - Fax:
Practice Address - Street 1:1745 NW 16TH ST STE A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-2078
Practice Address - Country:US
Practice Address - Phone:405-788-7348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-18
Last Update Date:2018-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula