Provider Demographics
NPI:1740896539
Name:MCCRARY, SARAH LOU (APRN-CNP)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LOU
Last Name:MCCRARY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 WESLEY ST STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-5635
Mailing Address - Country:US
Mailing Address - Phone:903-454-8111
Mailing Address - Fax:903-455-8001
Practice Address - Street 1:4101 WESLEY ST STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5635
Practice Address - Country:US
Practice Address - Phone:903-454-8111
Practice Address - Fax:903-455-8001
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1011152363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1011152OtherTEXAS BOARD OF NURSING