Provider Demographics
NPI:1356814321
Name:PATSY, SARAH ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:PATSY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3413 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2678
Mailing Address - Country:US
Mailing Address - Phone:814-868-9828
Mailing Address - Fax:
Practice Address - Street 1:3413 CHERRY ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2678
Practice Address - Country:US
Practice Address - Phone:814-868-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060429363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA060429OtherMEDICAL PHYSICIAN ASSISTANT LICENSE NUMBER