Provider Demographics
NPI:1346702362
Name:SASS, SARAH LINDSEY
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LINDSEY
Last Name:SASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N 36TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2954
Mailing Address - Country:US
Mailing Address - Phone:816-646-1667
Mailing Address - Fax:
Practice Address - Street 1:805 N 36TH ST STE B
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2954
Practice Address - Country:US
Practice Address - Phone:816-396-6026
Practice Address - Fax:816-398-6896
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013020991163WP0200X
KS53-78892-122363LP0200X
MO2019020048363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420073156Medicaid
KS201250970AMedicaid