Healthcare Provider Details

I. General information

NPI: 1255295200
Provider Name (Legal Business Name): SARA PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10593 DANIELSON AVE
LAS VEGAS NV
89129-6458
US

IV. Provider business mailing address

10593 DANIELSON AVE
LAS VEGAS NV
89129-6458
US

V. Phone/Fax

Practice location:
  • Phone: 661-433-8957
  • Fax:
Mailing address:
  • Phone: 661-433-8957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number815513
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: