Provider Demographics
NPI:1790258986
Name:NULTON, SARAH LYNETTE (CRNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNETTE
Last Name:NULTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-749-3181
Mailing Address - Fax:717-349-3191
Practice Address - Street 1:8131 SPYGLASS HILL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-5500
Practice Address - Country:US
Practice Address - Phone:717-749-3181
Practice Address - Fax:717-349-3191
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN703175163W00000X
PASP025736363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse