Provider Demographics
NPI:1275589053
Name:STANLEY, SARAH ROXANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ROXANNE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:170 MANNING DRIVE, CB 7235
Mailing Address - Street 2:DEPT. OF UROLOGY, 2113 PHYSICIAN'S OFFICE BUILDING
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599
Mailing Address - Country:US
Mailing Address - Phone:849-974-1315
Mailing Address - Fax:919-966-0098
Practice Address - Street 1:DEPARTMENT OF UROLOGY 2113 PHYSICIANS OFFICE
Practice Address - Street 2:170 MANNING DR., CB 7235
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-2586
Practice Address - Country:US
Practice Address - Phone:919-966-2574
Practice Address - Fax:919-966-0098
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001000340363A00000X
NC0010-00340363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2766784Medicare PIN
NCQ72862Medicare UPIN