Provider Demographics
NPI:1083296768
Name:MUSICK, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MUSICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143
Mailing Address - Country:US
Mailing Address - Phone:304-744-1112
Mailing Address - Fax:
Practice Address - Street 1:2806 38TH ST
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143
Practice Address - Country:US
Practice Address - Phone:304-744-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator