Provider Demographics
NPI:1952164162
Name:SEACREST, SARAH (RRT, SDS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SEACREST
Suffix:
Gender:F
Credentials:RRT, SDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 AVENIDA PASTORAL NW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-8365
Mailing Address - Country:US
Mailing Address - Phone:505-553-9429
Mailing Address - Fax:
Practice Address - Street 1:702 AVENIDA PASTORAL NW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8365
Practice Address - Country:US
Practice Address - Phone:505-553-9429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2298227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered