Provider Demographics
NPI:1467002493
Name:MCCLUNG, SARAH YACOBI (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:YACOBI
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ASHELY ANNE
Other - Last Name:YACOBI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1321 NEW GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2722
Mailing Address - Country:US
Mailing Address - Phone:363-299-0099
Mailing Address - Fax:336-299-0080
Practice Address - Street 1:1321 NEW GARDEN RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2722
Practice Address - Country:US
Practice Address - Phone:336-299-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09436363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant