Provider Demographics
NPI:1558084517
Name:POE, SARAH CATHERINE (APRN)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:CATHERINE
Last Name:POE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CATHERINE
Other - Last Name:DOONAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1861 N ROCK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-1264
Mailing Address - Country:US
Mailing Address - Phone:316-462-6285
Mailing Address - Fax:
Practice Address - Street 1:1861 N ROCK RD STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1264
Practice Address - Country:US
Practice Address - Phone:316-462-6285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSAPPLIED363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSAPPLIEDMedicaid