Provider Demographics
NPI:1225571714
Name:SCHIFFMAN, SARA REYNOLDS (ARNP, AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:REYNOLDS
Last Name:SCHIFFMAN
Suffix:
Gender:F
Credentials:ARNP, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 FERNDALE LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9110
Mailing Address - Country:US
Mailing Address - Phone:386-447-3775
Mailing Address - Fax:
Practice Address - Street 1:26 FERNDALE LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9110
Practice Address - Country:US
Practice Address - Phone:386-447-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9370537363L00000X, 363LA2200X, 363LP2300X, 364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology