Healthcare Provider Details
I. General information
NPI: 1801236518
Provider Name (Legal Business Name): SARAH CATHERINE LYNCH OBRADOVICH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/26/2013
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2140 SMITH ST
ORANGE PARK FL
32073-5554
US
IV. Provider business mailing address
PO BOX 44004
JACKSONVILLE FL
32231-4004
US
V. Phone/Fax
- Phone: 904-269-2140
- Fax: 904-376-4107
- Phone: 904-202-1032
- Fax: 904-376-4107
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | ARNP9306381 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: