Provider Demographics
NPI:1518692789
Name:WHITE, SARAH JEAN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JEAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3727 118TH LN NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2669
Mailing Address - Country:US
Mailing Address - Phone:763-600-4459
Mailing Address - Fax:
Practice Address - Street 1:190 CENTRAL AVE S
Practice Address - Street 2:
Practice Address - City:MILACA
Practice Address - State:MN
Practice Address - Zip Code:56353-1123
Practice Address - Country:US
Practice Address - Phone:224-487-4368
Practice Address - Fax:320-640-3166
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2113733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily