Provider Demographics
NPI:1952070690
Name:BOENIG, SARAH (AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:BOENIG
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HOSPITAL RD
Mailing Address - Street 2:A
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510
Mailing Address - Country:US
Mailing Address - Phone:337-893-1506
Mailing Address - Fax:
Practice Address - Street 1:136 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2819
Practice Address - Country:US
Practice Address - Phone:337-289-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221878363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner