Provider Demographics
NPI:1164969143
Name:DOLL, SARAH ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:DOLL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:DINNENY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:19401 E 39TH ST S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2308
Mailing Address - Country:US
Mailing Address - Phone:816-490-4277
Mailing Address - Fax:855-446-7160
Practice Address - Street 1:1513 MAIN ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-2538
Practice Address - Country:US
Practice Address - Phone:816-731-1890
Practice Address - Fax:833-996-1159
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012022930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily