Provider Demographics
NPI:1841755808
Name:HEROLD, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HEROLD
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 1:577 MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-1314
Mailing Address - Country:US
Mailing Address - Phone:443-938-3117
Mailing Address - Fax:
Practice Address - Street 1:577 MARGARET DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-1314
Practice Address - Country:US
Practice Address - Phone:443-938-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program