Provider Demographics
NPI:1881701092
Name:BROYLES, SARAH JACKLYN FLETCHER (PA C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JACKLYN FLETCHER
Last Name:BROYLES
Suffix:
Gender:F
Credentials:PA C
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Mailing Address - Street 1:10279 HURLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:VA
Mailing Address - Zip Code:24620
Mailing Address - Country:US
Mailing Address - Phone:276-566-7204
Mailing Address - Fax:276-546-9710
Practice Address - Street 1:10279 HURLEY RD
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:VA
Practice Address - Zip Code:24620
Practice Address - Country:US
Practice Address - Phone:276-566-7204
Practice Address - Fax:276-546-9710
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2018-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002406363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant