Provider Demographics
NPI:1255501102
Name:URBAN, SARAH J (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:URBAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-4068
Mailing Address - Country:US
Mailing Address - Phone:603-579-5190
Mailing Address - Fax:
Practice Address - Street 1:29 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-4068
Practice Address - Country:US
Practice Address - Phone:603-579-5190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant