Provider Demographics
NPI:1700382942
Name:YANCEY, SARA SOPHIA (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SOPHIA
Last Name:YANCEY
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 1:3223 E PALMER WASILLA HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7277
Mailing Address - Country:US
Mailing Address - Phone:907-352-6673
Mailing Address - Fax:907-376-3096
Practice Address - Street 1:3223 E PALMER WASILLA HWY STE 3
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7277
Practice Address - Country:US
Practice Address - Phone:907-352-6673
Practice Address - Fax:907-376-3096
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURR30711163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse