Provider Demographics
NPI:1558128041
Name:OLKOWSKI, SARA LOUISE (AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LOUISE
Last Name:OLKOWSKI
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LOUISE
Other - Last Name:STOTSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2867 NAUTILUS RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1607
Mailing Address - Country:US
Mailing Address - Phone:814-932-5623
Mailing Address - Fax:
Practice Address - Street 1:6129 PALMETTO ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-5729
Practice Address - Country:US
Practice Address - Phone:215-722-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026968363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care