Provider Demographics
NPI:1982061321
Name:NILES, SARAH E
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:NILES
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 1:46 HORSEBACK DR
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:ME
Mailing Address - Zip Code:04411-5320
Mailing Address - Country:US
Mailing Address - Phone:207-299-8976
Mailing Address - Fax:
Practice Address - Street 1:46 HORSEBACK DR
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:ME
Practice Address - Zip Code:04411-5320
Practice Address - Country:US
Practice Address - Phone:207-299-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care