Provider Demographics
NPI:1265109458
Name:PRAHM, SARAH (APRN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PRAHM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22867 ULMUS AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IA
Mailing Address - Zip Code:50464-8769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 S ILLINOIS AVE STE 100
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-5489
Practice Address - Country:US
Practice Address - Phone:641-428-6900
Practice Address - Fax:641-428-6909
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily