Provider Demographics
NPI:1205470564
Name:HART, SARAH KATHRYN (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHRYN
Last Name:HART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KATHRYN
Other - Last Name:TEMPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3528 GABEL RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7307
Mailing Address - Country:US
Mailing Address - Phone:406-373-8015
Mailing Address - Fax:406-373-8020
Practice Address - Street 1:3528 GABEL RD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7307
Practice Address - Country:US
Practice Address - Phone:406-373-8000
Practice Address - Fax:406-373-8020
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-80054363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical