Provider Demographics
NPI:1841603305
Name:KING, SARA (ARNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 W BENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-9700
Mailing Address - Country:US
Mailing Address - Phone:319-290-6245
Mailing Address - Fax:
Practice Address - Street 1:741 SOUTH ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:IA
Practice Address - Zip Code:50648-9397
Practice Address - Country:US
Practice Address - Phone:319-252-8718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR48437363LP0808X
IAG112010363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1841603305Medicaid