Provider Demographics
NPI:1124537816
Name:SEAGROVE, SARA NICOLE (APRN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:NICOLE
Last Name:SEAGROVE
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 VISTA DEL SOL DR STE 216
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7948
Mailing Address - Country:US
Mailing Address - Phone:915-591-2000
Mailing Address - Fax:915-591-2004
Practice Address - Street 1:10470 VISTA DEL SOL DR STE 216
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7948
Practice Address - Country:US
Practice Address - Phone:915-591-2000
Practice Address - Fax:915-591-2004
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135191363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care