Healthcare Provider Details

I. General information

NPI: 1295087492
Provider Name (Legal Business Name): SARAH LAURIE ARCHIBALD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH LAURIE BLEFELD NP

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COUNTY CIR
AMHERST MA
01003-9255
US

IV. Provider business mailing address

111 COUNTY CIR
AMHERST MA
01003-9255
US

V. Phone/Fax

Practice location:
  • Phone: 413-545-2337
  • Fax: 413-545-9602
Mailing address:
  • Phone: 413-545-2337
  • Fax: 413-545-9602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR202677
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1637248
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR202677
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0000441-NP
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2270550
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: