Healthcare Provider Details

I. General information

NPI: 1780009613
Provider Name (Legal Business Name): SARAH IBLINGS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2014
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508-6908
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 337-371-3101
  • Fax: 855-431-6867
Mailing address:
  • Phone: 225-765-5727
  • Fax: 225-765-4278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07723
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP07723
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: