Provider Demographics
NPI:1104186345
Name:SPRINGER, SARA (ANP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:KHURAIBET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 JUNGERMANN CIR STE 302
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1637
Mailing Address - Country:US
Mailing Address - Phone:636-706-5114
Mailing Address - Fax:636-720-0311
Practice Address - Street 1:14 JORDAN MARIE LN
Practice Address - Street 2:
Practice Address - City:OLD MONROE
Practice Address - State:MO
Practice Address - Zip Code:63369-2146
Practice Address - Country:US
Practice Address - Phone:636-720-0310
Practice Address - Fax:636-720-0311
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005024558363L00000X
MO2012009896363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner