Provider Demographics
NPI:1265720205
Name:WOODY, SARAH JANE (FNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:WOODY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:379 N 500 W STE 1A
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-1956
Mailing Address - Country:US
Mailing Address - Phone:970-640-0426
Mailing Address - Fax:
Practice Address - Street 1:379 N 500 W STE 1A
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-1956
Practice Address - Country:US
Practice Address - Phone:435-789-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT64458984405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily