Provider Demographics
NPI:1942085105
Name:MAYHEW, SARA JO (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:MAYHEW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 E HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:VALENTINE
Mailing Address - State:NE
Mailing Address - Zip Code:69201-2148
Mailing Address - Country:US
Mailing Address - Phone:402-650-6268
Mailing Address - Fax:
Practice Address - Street 1:1009 E HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:VALENTINE
Practice Address - State:NE
Practice Address - Zip Code:69201-2148
Practice Address - Country:US
Practice Address - Phone:402-650-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE97330163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse