Provider Demographics
NPI:1114456019
Name:VAIDA, SARAH A (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:VAIDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275-1311
Mailing Address - Country:US
Mailing Address - Phone:603-485-8441
Mailing Address - Fax:603-227-7563
Practice Address - Street 1:121 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275-1311
Practice Address - Country:US
Practice Address - Phone:603-485-8441
Practice Address - Fax:603-227-7563
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021138363LF0000X
NH080018-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily