Provider Demographics
NPI:1942031091
Name:BROWN, SARAH ELYSABETH (NP-BC)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ELYSABETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8093 SHEPHERD RD
Mailing Address - Street 2:
Mailing Address - City:WEEDSPORT
Mailing Address - State:NY
Mailing Address - Zip Code:13166-3197
Mailing Address - Country:US
Mailing Address - Phone:315-882-7201
Mailing Address - Fax:
Practice Address - Street 1:5794 WIDEWATERS PKWY
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1845
Practice Address - Country:US
Practice Address - Phone:315-422-1513
Practice Address - Fax:315-476-5950
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354989363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty