Provider Demographics
NPI:1992030274
Name:HLAD, SARA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:HLAD
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:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:KS
Mailing Address - Zip Code:67455-0467
Mailing Address - Country:US
Mailing Address - Phone:785-524-4474
Mailing Address - Fax:785-524-5320
Practice Address - Street 1:313 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:KS
Practice Address - Zip Code:67455-1751
Practice Address - Country:US
Practice Address - Phone:785-524-4474
Practice Address - Fax:785-524-5320
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501346363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1501346OtherSTATE LICENSE
KS171360OtherMEDICARE OSCAR/ CERTIFICATION
KS009814Medicare PIN