Provider Demographics
NPI:1942482930
Name:DOLANSKY, SARA MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:DOLANSKY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MARIE
Other - Last Name:FAUGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:8100 S. WALKER
Mailing Address - Street 2:BUILDING C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73158
Mailing Address - Country:US
Mailing Address - Phone:405-602-6500
Mailing Address - Fax:
Practice Address - Street 1:8100 S. WALKER
Practice Address - Street 2:BUILDING C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73158
Practice Address - Country:US
Practice Address - Phone:405-602-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0090721367500000X
CA681110163W00000X
TX699695163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100310Medicare PIN