Provider Demographics
NPI:1043662851
Name:IVEY, SARAH NEELY (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:NEELY
Last Name:IVEY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:AL
Mailing Address - Zip Code:36925-2117
Mailing Address - Country:US
Mailing Address - Phone:205-392-9656
Mailing Address - Fax:
Practice Address - Street 1:415 DERBY DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:AL
Practice Address - Zip Code:36925-2117
Practice Address - Country:US
Practice Address - Phone:205-392-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901553363LF0000X
AL3-001638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS521737YNJQMedicare PIN