Provider Demographics
NPI:1457666299
Name:CAMPANA, SARAH (GNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CAMPANA
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:KUCERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4114 POND HILL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1272
Mailing Address - Country:US
Mailing Address - Phone:210-249-5020
Mailing Address - Fax:210-572-1540
Practice Address - Street 1:4114 POND HILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1272
Practice Address - Country:US
Practice Address - Phone:210-249-5020
Practice Address - Fax:210-572-1540
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX647264363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX324677901Medicaid
TX324677901Medicaid