Healthcare Provider Details

I. General information

NPI: 1053182139
Provider Name (Legal Business Name): THE ON CALL FAMILY HEALTH NURSE PRACTITIONER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 SPRINGER RD
WEST SAND LAKE NY
12196-2035
US

IV. Provider business mailing address

PO BOX 183
WEST SAND LAKE NY
12196-0183
US

V. Phone/Fax

Practice location:
  • Phone: 518-738-7384
  • Fax:
Mailing address:
  • Phone: 518-738-7384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH OWENS
Title or Position: FAMILY HEALTH NURSE PRACTITIONER
Credential: NP
Phone: 518-738-7384