Provider Demographics
NPI:1568990950
Name:POLLARD, SARA SHIRLEEN (MSN, RN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SHIRLEEN
Last Name:POLLARD
Suffix:
Gender:F
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 E CAROL LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-6830
Mailing Address - Country:US
Mailing Address - Phone:1317-834-1667
Mailing Address - Fax:
Practice Address - Street 1:1635 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-3852
Practice Address - Country:US
Practice Address - Phone:317-524-3781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28137570A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health