Provider Demographics
NPI:1003266479
Name:WYLIE, SARAH KILPATRICK (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KILPATRICK
Last Name:WYLIE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5231 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9100
Mailing Address - Country:US
Mailing Address - Phone:225-769-0933
Mailing Address - Fax:225-769-6255
Practice Address - Street 1:5231 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9100
Practice Address - Country:US
Practice Address - Phone:225-769-0933
Practice Address - Fax:225-769-6255
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08843363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA71-0916908OtherTAX ID