Provider Demographics
NPI:1457911075
Name:SUTTON-MEYER, SARA JEAN
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JEAN
Last Name:SUTTON-MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:BURGAW
Mailing Address - State:NC
Mailing Address - Zip Code:28425-5011
Mailing Address - Country:US
Mailing Address - Phone:910-259-6973
Mailing Address - Fax:910-259-8002
Practice Address - Street 1:301 S CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425-5011
Practice Address - Country:US
Practice Address - Phone:910-259-5721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF06191390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily