Provider Demographics
NPI:1821266917
Name:ROBERTSON, SARA Z (NP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:Z
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:ZELIKOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:612 N GREENE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2024
Mailing Address - Country:US
Mailing Address - Phone:336-604-5100
Mailing Address - Fax:336-604-5151
Practice Address - Street 1:612 N GREENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2024
Practice Address - Country:US
Practice Address - Phone:336-604-5100
Practice Address - Fax:336-604-5151
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003965363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2593227Medicare PIN