Provider Demographics
NPI:1003241100
Name:TYLER, SARAH LOUISE (APRN)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LOUISE
Last Name:TYLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:LOUISE
Other - Last Name:HOAGLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 FLANDERS RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:324 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1735
Practice Address - Country:US
Practice Address - Phone:860-739-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008056168OtherMEDICAID 352 STATE STREET
CT008039745OtherPCS MEDICAID (BPT)
CT008056033OtherPCS MEDICAID CONGRESS
CT004217099OtherPCS MEDICAID LW
CT008056867OtherHOAGLAND MEDICAID #
CTWEAZY13OtherHOAGLAND SARAH APRN MEDICARE