MEDICARE: SARAH DORRIS

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	363LF0000X	Family Nurse Practitioner	2020033938	MO

General Provider Information

NPI Number	:	1548866171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DORRIS

Provider Business Mailing Address
First Line	:	9833 THREE OAKS LN
Second Line	:
City	:	BLOOMSDALE
State	:	MO
Zip	:	63627-9201
Country	:	US
Telephone Number	:
Fax Number	:	573-335-6724

Provider Business Practice Location Address
First Line	:	2215 BROADWAY ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-4403
Country	:	US
Telephone Number	:	573-271-5317
Fax Number	:	573-335-6724

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

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	04/08/2024

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Directions to “ SARAH DORRIS ” Practice Location

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