Provider Demographics
NPI:1821653379
Name:HARRELSON, SARAH (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HARRELSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HARRELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DEPASQUALE
Mailing Address - Street 1:88 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2499
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2499
Practice Address - Country:US
Practice Address - Phone:508-828-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2024-03-15
Deactivation Date:2019-05-09
Deactivation Code:
Reactivation Date:2019-06-27
Provider Licenses
StateLicense IDTaxonomies
MARN2298290363L00000X, 363L00000X, 363L00000X
NH072791-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner