Provider Demographics
NPI:1003882788
Name:BARNETT, SARAH J (PA C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:J
Last Name:BARNETT
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:VOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA C
Mailing Address - Street 1:1507 DOCTORS CT
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-4101
Mailing Address - Country:US
Mailing Address - Phone:920-261-4111
Mailing Address - Fax:920-262-1838
Practice Address - Street 1:1507 DOCTORS CT
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-4101
Practice Address - Country:US
Practice Address - Phone:920-261-4111
Practice Address - Fax:920-262-1838
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1613023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P42599Medicare UPIN
WI000930125Medicare Oscar/Certification