Provider Demographics
NPI:1972858397
Name:NACE, SARAH BETH (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:NACE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 MORMON TREK BLVD
Mailing Address - Street 2:#1500
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246
Mailing Address - Country:US
Mailing Address - Phone:319-337-7642
Mailing Address - Fax:
Practice Address - Street 1:2346 MORMON TREK BLVD STE 1500
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4368
Practice Address - Country:US
Practice Address - Phone:319-337-7642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51391363AM0700X
IA002285363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
10000002Medicare UPIN