Provider Demographics
NPI:1700161569
Name:NOWLIN, SARAH Y (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:Y
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 NOSTRAND AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4525
Mailing Address - Country:US
Mailing Address - Phone:352-246-7831
Mailing Address - Fax:
Practice Address - Street 1:7136 110TH ST STE SP1
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4873
Practice Address - Country:US
Practice Address - Phone:718-268-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30 305833363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health