Provider Demographics
NPI:1407000789
Name:ALKE, SARAH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:ALKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MOELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:935 HIGHLAND BLVD
Mailing Address - Street 2:STE 2210
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6903
Mailing Address - Country:US
Mailing Address - Phone:406-414-4260
Mailing Address - Fax:
Practice Address - Street 1:214 E MENDENHALL ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3638
Practice Address - Country:US
Practice Address - Phone:406-585-1360
Practice Address - Fax:406-823-6305
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT555363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT247936Medicaid
MT266942Medicaid