Provider Demographics
NPI:1811637358
Name:THOMAS, SARAH HODGE (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:HODGE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:233 HACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-4398
Mailing Address - Country:US
Mailing Address - Phone:270-454-0393
Mailing Address - Fax:
Practice Address - Street 1:230 N GREEN ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-3109
Practice Address - Country:US
Practice Address - Phone:270-854-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012624A363L00000X
KY3017573363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily