Provider Demographics
NPI:1760017123
Name:ROTTMAN, SARA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ROTTMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W BENSON BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3677
Mailing Address - Country:US
Mailing Address - Phone:907-929-4009
Mailing Address - Fax:
Practice Address - Street 1:1400 W BENSON BLVD STE 315
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3677
Practice Address - Country:US
Practice Address - Phone:907-929-4009
Practice Address - Fax:907-929-4902
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK156651363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health