Provider Demographics
NPI:1629628235
Name:WILKINS, SARAH (EMT-P)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SWISHER VIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-9530
Mailing Address - Country:US
Mailing Address - Phone:319-350-6855
Mailing Address - Fax:
Practice Address - Street 1:200 SWISHER VIEW DR SW
Practice Address - Street 2:
Practice Address - City:SWISHER
Practice Address - State:IA
Practice Address - Zip Code:52338-9530
Practice Address - Country:US
Practice Address - Phone:319-350-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10-1600-25146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA10-1600-25OtherEMT LICENSE IOWA