Provider Demographics
NPI:1134190788
Name:HARKNESS, SARA LYNN (FNP)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:LYNN
Last Name:HARKNESS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 GLORIETTA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3503
Mailing Address - Country:US
Mailing Address - Phone:925-253-0118
Mailing Address - Fax:
Practice Address - Street 1:111 GLORIETTA BLVD
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3503
Practice Address - Country:US
Practice Address - Phone:925-253-0118
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503035363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology