Provider Demographics
NPI:1912571282
Name:SMITH, SARAH LARRAINE (APRN, MSN-FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LARRAINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN, MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1701 E BROADWAY STE 204
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8018
Mailing Address - Country:US
Mailing Address - Phone:573-815-6447
Mailing Address - Fax:573-815-3816
Practice Address - Street 1:1701 E BROADWAY STE 204
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8018
Practice Address - Country:US
Practice Address - Phone:573-815-6447
Practice Address - Fax:573-815-3816
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2021017871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily