Provider Demographics
NPI:1801610308
Name:GAY, SARA MICHELLE (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MICHELLE
Last Name:GAY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SEA MIST LN
Mailing Address - Street 2:
Mailing Address - City:BACLIFF
Mailing Address - State:TX
Mailing Address - Zip Code:77518-2773
Mailing Address - Country:US
Mailing Address - Phone:785-342-2773
Mailing Address - Fax:
Practice Address - Street 1:310 SEA MIST LN
Practice Address - Street 2:
Practice Address - City:BACLIFF
Practice Address - State:TX
Practice Address - Zip Code:77518-2773
Practice Address - Country:US
Practice Address - Phone:785-342-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX816066163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant