Provider Demographics
NPI:1659847762
Name:CHASE, SARAH FAIRLIGHT (DEM)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:FAIRLIGHT
Last Name:CHASE
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-0732
Mailing Address - Country:US
Mailing Address - Phone:801-808-3297
Mailing Address - Fax:
Practice Address - Street 1:1132 21ST ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-0732
Practice Address - Country:US
Practice Address - Phone:801-808-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay