Healthcare Provider Details

I. General information

NPI: 1376591586
Provider Name (Legal Business Name): SARAH CATHERINE O'TOOLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH CATHERINE BAILEY RN

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BLVD
WINSTON-SALEM NC
27157-1089
US

IV. Provider business mailing address

PO BOX 344
WINSTON SALEM NC
27102-0344
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-2255
  • Fax:
Mailing address:
  • Phone: 336-716-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number106436
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: