Provider Demographics
NPI:1467842153
Name:HELLWEGE, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HELLWEGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2610
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-2610
Mailing Address - Country:US
Mailing Address - Phone:256-241-0885
Mailing Address - Fax:256-847-8536
Practice Address - Street 1:112 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3361
Practice Address - Country:US
Practice Address - Phone:252-384-2610
Practice Address - Fax:252-338-2505
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCNM NO. 557367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife