Provider Demographics
NPI:1740720465
Name:BROUGHTON, SARAH (FNP-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BROUGHTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 NE RALPH POWELL RD STE A
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2316
Mailing Address - Country:US
Mailing Address - Phone:816-836-2200
Mailing Address - Fax:816-836-2244
Practice Address - Street 1:3601 NE RALPH POWELL RD STE A
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2316
Practice Address - Country:US
Practice Address - Phone:816-836-2200
Practice Address - Fax:816-836-2244
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-77554-031363LF0000X
MO2017003426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily