Provider Demographics
NPI:1558794362
Name:GODBEY, SARAH E (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:GODBEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HAIL KNOB RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3434
Mailing Address - Country:US
Mailing Address - Phone:606-678-9617
Mailing Address - Fax:606-678-9619
Practice Address - Street 1:75 HAIL KNOB RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3434
Practice Address - Country:US
Practice Address - Phone:606-678-9617
Practice Address - Fax:606-678-9619
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC213363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical