Healthcare Provider Details
I. General information
NPI: 1851319230
Provider Name (Legal Business Name): SARA E. MIDWOOD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/17/2006
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1040 REED AVE
WYOMISSING PA
19610-2029
US
IV. Provider business mailing address
PO BOX 13579
READING PA
19612-3579
US
V. Phone/Fax
- Phone: 610-898-7040
- Fax:
- Phone: 484-628-1324
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | LH-0000227 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | SP008390 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | SP008390 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: