Provider Demographics
NPI:1760179436
Name:LOPIENSKI, SARAH SHANLEY (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:SHANLEY
Last Name:LOPIENSKI
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:SHANLEY
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 ANDROS WAY
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-4005
Mailing Address - Country:US
Mailing Address - Phone:928-642-0008
Mailing Address - Fax:
Practice Address - Street 1:5113 N DAVIS HWY STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2035
Practice Address - Country:US
Practice Address - Phone:850-290-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG02230013363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology