Provider Demographics
NPI:1881016384
Name:BRENNER, SARAH L (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:BRENNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2106 HARRISBURG PIKE STE 116
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-393-1900
Mailing Address - Fax:717-553-5040
Practice Address - Street 1:2106 HARRISBURG PIKE STE 116
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-393-1900
Practice Address - Fax:717-553-5040
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056702363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical