Provider Demographics
NPI:1477301125
Name:AGUIRRE, SARAH NICOLLE (APN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLLE
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9752
Mailing Address - Country:US
Mailing Address - Phone:609-272-0909
Mailing Address - Fax:
Practice Address - Street 1:6010 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9752
Practice Address - Country:US
Practice Address - Phone:609-272-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15019100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health