Healthcare Provider Details

I. General information

NPI: 1023824596
Provider Name (Legal Business Name): MRS. SARA LYNN ART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11109 PARKVIEW PLAZA DR
FORT WAYNE IN
46845-1701
US

IV. Provider business mailing address

322 N LINE ST
COLUMBIA CITY IN
46725-1737
US

V. Phone/Fax

Practice location:
  • Phone: 260-428-3055
  • Fax:
Mailing address:
  • Phone: 260-248-7513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number28239459A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: