Provider Demographics
NPI:1487343349
Name:CARRILLO, SARAH KATHRYN (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KATHRYN
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 PONDEROSA CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6037
Mailing Address - Country:US
Mailing Address - Phone:903-217-9959
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR STE 21112
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:737-279-7200
Practice Address - Fax:737-279-7300
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily