Provider Demographics
NPI:1407487093
Name:SPROUSE, SARAH B MECHELLE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:B MECHELLE
Last Name:SPROUSE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PUTNAM VILLAGE DR.
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526
Mailing Address - Country:US
Mailing Address - Phone:304-757-0057
Mailing Address - Fax:
Practice Address - Street 1:2500 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-1530
Practice Address - Country:US
Practice Address - Phone:304-675-2230
Practice Address - Fax:304-675-2234
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.026503363LF0000X
WV105533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily