Provider Demographics
NPI:1891773750
Name:WALTHER, SARA (ARNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WALTHER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MOORINGS PARK DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2122
Mailing Address - Country:US
Mailing Address - Phone:239-430-9391
Mailing Address - Fax:239-430-6394
Practice Address - Street 1:120 MOORINGS PARK DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-2122
Practice Address - Country:US
Practice Address - Phone:239-430-6391
Practice Address - Fax:239-430-6394
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9383357363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHW107YOtherMEDICARE
FLY0MT3OtherBCBS