Provider Demographics
NPI:1073742227
Name:BERNS, SARA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:BERNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:TECHAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1007 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52213-9451
Mailing Address - Country:US
Mailing Address - Phone:319-521-7662
Mailing Address - Fax:
Practice Address - Street 1:204 8TH AVE SE
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-2448
Practice Address - Country:US
Practice Address - Phone:319-521-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002004207P00000X
IA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00777833 CC6519OtherRR MEDICARE
IA1073742227OtherBLUE SHIELD
IAP00777833 CC6519OtherRR MEDICARE
IA71926081Medicare PIN