Healthcare Provider Details

I. General information

NPI: 1487582045
Provider Name (Legal Business Name): SARAH ALYSE UNRUH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

711 GENN DR
WAMEGO KS
66547-1179
US

IV. Provider business mailing address

519 N MANHATTAN AVE APT 4
MANHATTAN KS
66502-5380
US

V. Phone/Fax

Practice location:
  • Phone: 785-456-2295
  • Fax:
Mailing address:
  • Phone: 620-490-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: