Provider Demographics
NPI:1962293258
Name:WATSON, SARAH JANE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:WATSON
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 1:525 FLINTROCK HL
Mailing Address - Street 2:
Mailing Address - City:PETROLEUM
Mailing Address - State:WV
Mailing Address - Zip Code:26161-6473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:525 FLINTROCK HL
Practice Address - Street 2:
Practice Address - City:PETROLEUM
Practice Address - State:WV
Practice Address - Zip Code:26161-6473
Practice Address - Country:US
Practice Address - Phone:304-628-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide