Provider Demographics
NPI:1982230736
Name:DONOVAN, SARA LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LOUISE
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LOUISE
Other - Last Name:STRASSENBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4334
Mailing Address - Country:US
Mailing Address - Phone:617-417-4552
Mailing Address - Fax:
Practice Address - Street 1:50 MALDEN ST APT 523
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2893
Practice Address - Country:US
Practice Address - Phone:617-417-4552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN284869363LF0000X
MA284869163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily