Healthcare Provider Details

I. General information

NPI: 1982230736
Provider Name (Legal Business Name): SARA LOUISE DONOVAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA LOUISE STRASSENBURG

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MALDEN ST APT 523
BOSTON MA
02118-2893
US

IV. Provider business mailing address

65 HERITAGE LN
DUXBURY MA
02332-4334
US

V. Phone/Fax

Practice location:
  • Phone: 617-417-4552
  • Fax:
Mailing address:
  • Phone: 617-417-4552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN284869
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number284869
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: