Provider Demographics
NPI:1982057527
Name:BYRD, SARAH (CFNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SUSHRUTA DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8876
Mailing Address - Country:US
Mailing Address - Phone:304-263-3933
Mailing Address - Fax:304-596-5554
Practice Address - Street 1:1000 SUSHRUTA DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8876
Practice Address - Country:US
Practice Address - Phone:304-263-3933
Practice Address - Fax:304-596-5554
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVF0616050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001978551OtherBCBS
WV3810009620Medicaid