Provider Demographics
NPI:1477135242
Name:BULL, SARAH (CRNP, AGNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BULL
Suffix:
Gender:F
Credentials:CRNP, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MAPLE SHADE AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1440
Mailing Address - Country:US
Mailing Address - Phone:410-215-4837
Mailing Address - Fax:
Practice Address - Street 1:638 NEWTOWN YARDLEY RD STE 2E
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1738
Practice Address - Country:US
Practice Address - Phone:215-968-1616
Practice Address - Fax:215-860-1976
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN669325163W00000X
PA390200000X
PASP023678363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA56-2424638OtherFAMILY PRACTICE TAX ID