Provider Demographics
NPI:1457998973
Name:WHITFIELD, SARAH E
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BAUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 CAMDEN CIR APT 301
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-6015
Mailing Address - Country:US
Mailing Address - Phone:208-507-0244
Mailing Address - Fax:
Practice Address - Street 1:138 CAMDEN CIR APT 301
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-6015
Practice Address - Country:US
Practice Address - Phone:208-507-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2381363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant