Healthcare Provider Details

I. General information

NPI: 1558697094
Provider Name (Legal Business Name): SARAH VAN SAUN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2009
Last Update Date: 10/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 LENOX ST
NORWOOD MA
02062-3416
US

IV. Provider business mailing address

190 LENOX ST
NORWOOD MA
02062-3416
US

V. Phone/Fax

Practice location:
  • Phone: 781-769-8670
  • Fax:
Mailing address:
  • Phone: 781-769-8670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN284441
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN284441
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: