Provider Demographics
NPI:1942860820
Name:GAUL, SARAH ANNE LIST
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE LIST
Last Name:GAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 N WOODROW CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-2952
Mailing Address - Country:US
Mailing Address - Phone:316-833-8926
Mailing Address - Fax:
Practice Address - Street 1:105 S ANDOVER RD STE A
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-7924
Practice Address - Country:US
Practice Address - Phone:316-833-8926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay