Healthcare Provider Details

I. General information

NPI: 1386583276
Provider Name (Legal Business Name): SARAH JEAN ARCHER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 MISSION AVE NE
ALBUQUERQUE NM
87107-4909
US

IV. Provider business mailing address

1413 MARRON CIR NE
ALBUQUERQUE NM
87112-3841
US

V. Phone/Fax

Practice location:
  • Phone: 505-344-5269
  • Fax:
Mailing address:
  • Phone: 505-344-5269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number75919
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: