Provider Demographics
NPI:1609962083
Name:WEDDLE, SARAH LEIGH (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LEIGH
Last Name:WEDDLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:1550 HIGHWAY 1275 N
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-7210
Mailing Address - Country:US
Mailing Address - Phone:606-340-2923
Mailing Address - Fax:606-348-8496
Practice Address - Street 1:1 S CREEK DR STE 102
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-9472
Practice Address - Country:US
Practice Address - Phone:606-348-3365
Practice Address - Fax:606-348-8496
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY4969P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100030880Medicaid
KY7100030880Medicaid