Healthcare Provider Details

I. General information

NPI: 1790258986
Provider Name (Legal Business Name): SARAH LYNETTE NULTON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH FISHER

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ST PAUL DR
CHAMBERSBURG PA
17201-1036
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-6944
  • Fax: 717-303-3729
Mailing address:
  • Phone: 717-749-3181
  • Fax: 717-349-3191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN703175
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP025736
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: