Provider Demographics
NPI:1275924821
Name:CUSHMAN, SARAH ANN (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:CUSHMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 E STEARNS ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6241
Mailing Address - Country:US
Mailing Address - Phone:479-445-6460
Mailing Address - Fax:479-445-6719
Practice Address - Street 1:1280 E STEARNS ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6241
Practice Address - Country:US
Practice Address - Phone:479-445-6460
Practice Address - Fax:479-445-6719
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004332363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care