Healthcare Provider Details

I. General information

NPI: 1427470459
Provider Name (Legal Business Name): SARAH WILLS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH SCHMERLER CRNA

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

68 S SERVICE RD SUITE 350
MELVILLE NY
11747-2354
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-9000
  • Fax:
Mailing address:
  • Phone: 516-945-3000
  • Fax: 516-945-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR178615
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: