Provider Demographics
NPI:1811589765
Name:EMMONS, SARAH MAE
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MAE
Last Name:EMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 462
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:OR
Mailing Address - Zip Code:97533-0462
Mailing Address - Country:US
Mailing Address - Phone:541-226-8179
Mailing Address - Fax:
Practice Address - Street 1:212 BLUE WATER LN
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-9400
Practice Address - Country:US
Practice Address - Phone:541-226-8179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula