Provider Demographics
NPI:1760851976
Name:LUONG, SARAH A (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:LUONG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:ERWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1909 GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-4826
Mailing Address - Country:US
Mailing Address - Phone:618-593-4494
Mailing Address - Fax:
Practice Address - Street 1:4500 MEMORIAL DRIVE
Practice Address - Street 2:CEP AMERICA- HOSPITALIST MEMORIAL HOSPITAL
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226
Practice Address - Country:US
Practice Address - Phone:618-257-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013310363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily