Provider Demographics
NPI:1457706012
Name:BAXLEY, SARAH J (DNP)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:BAXLEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 NAUTICA WAY
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2526
Mailing Address - Country:US
Mailing Address - Phone:850-842-1403
Mailing Address - Fax:844-342-0852
Practice Address - Street 1:240 NAUTICA WAY
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2526
Practice Address - Country:US
Practice Address - Phone:850-757-9046
Practice Address - Fax:844-342-0852
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009672363LF0000X
FLAPRN1457706012364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F0316655OtherAANCP