Provider Demographics
NPI:1861037012
Name:KINGMAN, SARAH (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KINGMAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 FOWLER RD
Mailing Address - Street 2:
Mailing Address - City:WHITINGHAM
Mailing Address - State:VT
Mailing Address - Zip Code:05361-9626
Mailing Address - Country:US
Mailing Address - Phone:802-368-2493
Mailing Address - Fax:
Practice Address - Street 1:131 KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-664-8717
Practice Address - Fax:413-665-9383
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2313889163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health