Provider Demographics
NPI:1841306586
Name:EGGEMEIER, SARA B (APN, CNM)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:B
Last Name:EGGEMEIER
Suffix:
Gender:F
Credentials:APN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HOSPITAL DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-6603
Mailing Address - Country:US
Mailing Address - Phone:413-535-4714
Mailing Address - Fax:
Practice Address - Street 1:15 HOSPITAL DR STE 501
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6606
Practice Address - Country:US
Practice Address - Phone:413-534-2826
Practice Address - Fax:413-534-2829
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-006137367A00000X
MARN243716367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN243716OtherSTATE LICENSE