Provider Demographics
NPI:1942870506
Name:CRAVEN, SARAH DALE (MSN, APRN, AGNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:DALE
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:MSN, APRN, AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3343 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4917
Mailing Address - Country:US
Mailing Address - Phone:316-260-4110
Mailing Address - Fax:
Practice Address - Street 1:3343 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4917
Practice Address - Country:US
Practice Address - Phone:316-260-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS83232363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner