Provider Demographics
NPI:1508684150
Name:CONRAD, SARA ELIZABETH (DNP, APRN, PMHNP)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELIZABETH
Last Name:CONRAD
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 LOWELL MILL RD
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-8628
Mailing Address - Country:US
Mailing Address - Phone:919-307-0343
Mailing Address - Fax:
Practice Address - Street 1:233 WINTON BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3507
Practice Address - Country:US
Practice Address - Phone:334-239-2622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29454363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health