Provider Demographics
NPI:1831808567
Name:MCLEMORE, SARAH GRACE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GRACE
Last Name:MCLEMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:GRACE
Other - Last Name:FORTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:424 PARAMOUNT LN
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1536
Mailing Address - Country:US
Mailing Address - Phone:207-713-2683
Mailing Address - Fax:
Practice Address - Street 1:424 PARAMOUNT LN
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-1536
Practice Address - Country:US
Practice Address - Phone:207-713-2683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant