Provider Demographics
NPI:1003645300
Name:MADSEN, SARAH (RN, PMHNP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:MADSEN
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CRAIG AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3216
Mailing Address - Country:US
Mailing Address - Phone:907-590-5806
Mailing Address - Fax:
Practice Address - Street 1:1025 W BARNETTE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4539
Practice Address - Country:US
Practice Address - Phone:907-451-1665
Practice Address - Fax:907-451-1661
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK12508363L00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner