Provider Demographics
NPI:1114465135
Name:MYER, SARAH (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MYER
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38868 12TH AVE # 1083
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-6658
Mailing Address - Country:US
Mailing Address - Phone:651-333-3677
Mailing Address - Fax:612-500-4553
Practice Address - Street 1:38868 12TH AVE # 1083
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-6658
Practice Address - Country:US
Practice Address - Phone:651-401-5626
Practice Address - Fax:612-500-4553
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP5004363LP0808X
MNCNP 5004363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics