Provider Demographics
NPI:1568561595
Name:WHELLEY, SARAH (ARNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WHELLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:MOULTONBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03254-0500
Mailing Address - Country:US
Mailing Address - Phone:603-476-5366
Mailing Address - Fax:
Practice Address - Street 1:298 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-4204
Practice Address - Country:US
Practice Address - Phone:603-447-8900
Practice Address - Fax:603-447-4846
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0325192303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010918Medicaid
9111170OtherCIGNA
1329908OtherAETNA
P74005OtherHARVARD PILGRIM HEALTH
1329908OtherAETNA
NH30010918Medicaid