Healthcare Provider Details

I. General information

NPI: 1134462567
Provider Name (Legal Business Name): SARAH KATHRYN BABAYEV CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH KATHRYN ATKINSON CRNP

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRUCE ST PINE 1 WEST
PHILADELPHIA PA
19107-6130
US

IV. Provider business mailing address

800 SPRUCE ST PINE 1 WEST
PHILADELPHIA PA
19107-6130
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-7817
  • Fax:
Mailing address:
  • Phone: 215-829-7817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP012817
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: