Provider Demographics
NPI:1407190663
Name:BENRATH, SARAH LEOLA (MPH, MSN, PNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LEOLA
Last Name:BENRATH
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Gender:F
Credentials:MPH, MSN, PNP-BC
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Mailing Address - Street 1:600 SW COLUMBIA ST STE 6250
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1099
Mailing Address - Country:US
Mailing Address - Phone:541-383-3005
Mailing Address - Fax:541-383-1883
Practice Address - Street 1:230 NE 6TH ST RM S-19
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5103
Practice Address - Country:US
Practice Address - Phone:541-383-3005
Practice Address - Fax:541-383-1883
Is Sole Proprietor?:No
Enumeration Date:2012-11-11
Last Update Date:2023-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA60434628363LP0200X
NY382329363LP0200X
OR202011070NP-PP364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics