Provider Demographics
NPI:1710068358
Name:KOEHLER, SARAH (CRNA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 9328
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-0018
Mailing Address - Country:US
Mailing Address - Phone:662-327-3881
Mailing Address - Fax:662-329-1283
Practice Address - Street 1:294 SAVELLE CIR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-3228
Practice Address - Country:US
Practice Address - Phone:662-327-3881
Practice Address - Fax:662-329-1283
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR605824367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered