Healthcare Provider Details

I. General information

NPI: 1326685272
Provider Name (Legal Business Name): SARAH CAITLYN WEINGARDT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH SARAH BAGGETTE PA

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12896 DEER BANK RD
FISHERS IN
46037-4624
US

IV. Provider business mailing address

12896 DEER BANK RD
FISHERS IN
46037-4624
US

V. Phone/Fax

Practice location:
  • Phone: 217-899-1015
  • Fax:
Mailing address:
  • Phone: 217-899-1015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10002882A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: