Provider Demographics
NPI:1790515294
Name:PRICHARD, SARAH (PMHNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PRICHARD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MCMANIMIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7725 N WALLACE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-1424
Mailing Address - Country:US
Mailing Address - Phone:636-288-1149
Mailing Address - Fax:
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024029378363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health