Healthcare Provider Details

I. General information

NPI: 1639003197
Provider Name (Legal Business Name): SARA OWENS HALSEY FNP-C, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 HEALTH SERVICES RD
SPARTA NC
28675-3000
US

IV. Provider business mailing address

157 HEALTH SERVICES RD
SPARTA NC
28675-3000
US

V. Phone/Fax

Practice location:
  • Phone: 336-372-5641
  • Fax: 336-372-1888
Mailing address:
  • Phone: 336-372-5641
  • Fax: 336-372-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001212727
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024852
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: