Healthcare Provider Details

I. General information

NPI: 1396267183
Provider Name (Legal Business Name): SARAH ANN WREN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 GRIDER ST
BUFFALO NY
14215-3021
US

IV. Provider business mailing address

280 BEALE AVE
CHEEKTOWAGA NY
14225-2120
US

V. Phone/Fax

Practice location:
  • Phone: 716-898-3000
  • Fax:
Mailing address:
  • Phone: 716-909-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number341955
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF341955-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: