Provider Demographics
NPI:1205145240
Name:LAMPORT, SARAH ROSE M (NP)
Entity type:Individual
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First Name:SARAH ROSE
Middle Name:M
Last Name:LAMPORT
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:117 ELLENFIELD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4513
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:375 WAMPANOAG TRL
Practice Address - Street 2:SUITE 102
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2212
Practice Address - Country:US
Practice Address - Phone:401-649-4010
Practice Address - Fax:401-649-4011
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2019-02-25
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Provider Licenses
StateLicense IDTaxonomies
RIAPRN01180363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner