Provider Demographics
NPI:1457059990
Name:MAY, SARAH GRACE (DNP FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:MAY
Suffix:
Gender:F
Credentials:DNP FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:GRACE
Other - Last Name:ELLENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 CAMINO DEL RIO S STE 530
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3503
Mailing Address - Country:US
Mailing Address - Phone:559-593-5479
Mailing Address - Fax:
Practice Address - Street 1:404 CAMINO DEL RIO S STE 530
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3503
Practice Address - Country:US
Practice Address - Phone:559-593-5479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95023955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily