Provider Demographics
NPI:1003188830
Name:ASSANTE, SARAH ADRIENNE (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ADRIENNE
Last Name:ASSANTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 KILDAIRE FARM RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3922
Mailing Address - Country:US
Mailing Address - Phone:919-319-6610
Mailing Address - Fax:919-319-6365
Practice Address - Street 1:907 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3922
Practice Address - Country:US
Practice Address - Phone:919-319-6610
Practice Address - Fax:919-319-6365
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001014351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1003188830Medicaid
VA1003188830Medicaid