Provider Demographics
NPI:1437818606
Name:TWARDY, SARA HOLLY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:HOLLY
Last Name:TWARDY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7552 W 82ND CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-9611
Mailing Address - Country:US
Mailing Address - Phone:219-314-8954
Mailing Address - Fax:
Practice Address - Street 1:322 US HIGHWAY 41 STE 103
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-4204
Practice Address - Country:US
Practice Address - Phone:219-322-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041389207163W00000X
IN28193584A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse