Provider Demographics
NPI:1518944321
Name:THOMSON, SARA J (CNM)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:THOMSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RTE 40 E
Mailing Address - Street 2:P O BOX 10
Mailing Address - City:FARMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15437-0010
Mailing Address - Country:US
Mailing Address - Phone:724-329-8573
Mailing Address - Fax:724-329-1230
Practice Address - Street 1:2255 PLATTE CLOVE RD
Practice Address - Street 2:
Practice Address - City:ELKA PARK
Practice Address - State:NY
Practice Address - Zip Code:12427-1014
Practice Address - Country:US
Practice Address - Phone:845-481-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN321822L163W00000X
NY416216163W00000X
PAMW010103367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMW010103OtherMIDWIFE LICENSE
PA101309251 0001Medicaid
PARN321822LOtherRN LICENSE
PA101309251 0001Medicaid
P19380Medicare UPIN