Provider Demographics
NPI:1184210866
Name:TIPTON, SARAH FAYE (CRNA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:FAYE
Last Name:TIPTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 3RD AVE NE STE 200
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5044
Mailing Address - Country:US
Mailing Address - Phone:828-327-8105
Mailing Address - Fax:828-327-4245
Practice Address - Street 1:10 3RD AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5044
Practice Address - Country:US
Practice Address - Phone:828-327-8105
Practice Address - Fax:828-327-4245
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029370367500000X
NC131075367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered