Provider Demographics
NPI:1508655176
Name:DESELMS, SARAH MARIE
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:MARIE
Last Name:DESELMS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 N 93RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3913
Mailing Address - Country:US
Mailing Address - Phone:402-672-2413
Mailing Address - Fax:
Practice Address - Street 1:3621 N 93RD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3913
Practice Address - Country:US
Practice Address - Phone:402-672-2413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist