Provider Demographics
NPI:1932885720
Name:ROBERTS, SARA ANN
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 BRANDONVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:TERRA ALTA
Mailing Address - State:WV
Mailing Address - Zip Code:26764
Mailing Address - Country:US
Mailing Address - Phone:681-270-9813
Mailing Address - Fax:
Practice Address - Street 1:975 BRANDONVILLE PIKE
Practice Address - Street 2:
Practice Address - City:TERRA ALTA
Practice Address - State:WV
Practice Address - Zip Code:26764
Practice Address - Country:US
Practice Address - Phone:681-270-9813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant