Healthcare Provider Details

I. General information

NPI: 1053932970
Provider Name (Legal Business Name): SARAH LYNNE WEBER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S STATE ROAD 135 STE C
TRAFALGAR IN
46181-8702
US

IV. Provider business mailing address

106 S STATE ROAD 135 STE C
TRAFALGAR IN
46181-8702
US

V. Phone/Fax

Practice location:
  • Phone: 317-878-4972
  • Fax: 317-878-4593
Mailing address:
  • Phone: 317-878-4972
  • Fax: 317-878-4593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71009985A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: