Provider Demographics
NPI:1346769171
Name:MARSH, SARAH E (APN FNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:MARSH
Suffix:
Gender:F
Credentials:APN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 857
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-0857
Mailing Address - Country:US
Mailing Address - Phone:815-599-7925
Mailing Address - Fax:815-599-7923
Practice Address - Street 1:1045 W STEPHENSON ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-4864
Practice Address - Country:US
Practice Address - Phone:815-599-6446
Practice Address - Fax:815-599-6933
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016475363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily