Healthcare Provider Details

I. General information

NPI: 1437950136
Provider Name (Legal Business Name): SARAH EILEEN OERTHER FNP-BC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOVERS LN
ROLLA MO
65401-3622
US

IV. Provider business mailing address

200 LOVERS LN
ROLLA MO
65401-3622
US

V. Phone/Fax

Practice location:
  • Phone: 573-465-8319
  • Fax:
Mailing address:
  • Phone: 573-465-8319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025010749
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2010017332
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: