Provider Demographics
NPI:1356604268
Name:DILLON, SARA K (NP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:K
Last Name:DILLON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:K
Other - Last Name:BAUMGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 3407
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47733-3407
Mailing Address - Country:US
Mailing Address - Phone:812-858-3131
Mailing Address - Fax:812-858-3140
Practice Address - Street 1:4133 GATEWAY BLVD STE 220
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7918
Practice Address - Country:US
Practice Address - Phone:812-858-3131
Practice Address - Fax:812-858-3140
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004026A363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner