Provider Demographics
NPI:1265942460
Name:RADERER, SARAH EMPSON (ARNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:EMPSON
Last Name:RADERER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4691
Mailing Address - Country:US
Mailing Address - Phone:812-949-0405
Mailing Address - Fax:812-949-0445
Practice Address - Street 1:2305 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4691
Practice Address - Country:US
Practice Address - Phone:812-949-0405
Practice Address - Fax:812-949-0445
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007538A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics