Provider Demographics
NPI:1306228291
Name:SMITH, SARAH BREANNE (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BREANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W WHEATLAND RD
Mailing Address - Street 2:PAV III STE#360
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4408
Mailing Address - Country:US
Mailing Address - Phone:214-884-4700
Mailing Address - Fax:214-884-4761
Practice Address - Street 1:1411 N BECKLEY AVE
Practice Address - Street 2:PAV III STE#152
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203
Practice Address - Country:US
Practice Address - Phone:214-948-2076
Practice Address - Fax:214-948-9990
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily