Provider Demographics
NPI:1609539717
Name:COLLINS, SARAH (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W FAIRCHILD HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRCHILD AFB
Mailing Address - State:WA
Mailing Address - Zip Code:99011-8676
Mailing Address - Country:US
Mailing Address - Phone:509-565-3607
Mailing Address - Fax:
Practice Address - Street 1:400 W FAIRCHILD HWY
Practice Address - Street 2:
Practice Address - City:FAIRCHILD AFB
Practice Address - State:WA
Practice Address - Zip Code:99011-8676
Practice Address - Country:US
Practice Address - Phone:509-565-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA21556932163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool