MEDICARE: SARAH EGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1033530456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH EGAN

Provider Business Mailing Address
First Line	:	3948 BADGERBROOK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6413
Country	:	US
Telephone Number	:	925-980-4480
Fax Number	:

Provider Business Practice Location Address
First Line	:	3948 BADGERBROOK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6413
Country	:	US
Telephone Number	:	925-980-4480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2014
Last Update Date	:	01/02/2014

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Directions to “ SARAH EGAN ” Practice Location

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