Provider Demographics
NPI:1003696543
Name:SUROWIEC, SARAH MARIE (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:SUROWIEC
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E TACOMA AVE
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1143
Mailing Address - Country:US
Mailing Address - Phone:724-875-6263
Mailing Address - Fax:
Practice Address - Street 1:112 E TACOMA AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1143
Practice Address - Country:US
Practice Address - Phone:724-875-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily