Healthcare Provider Details

I. General information

NPI: 1841714763
Provider Name (Legal Business Name): SARAH STAPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WELLS ST FL 2
WESTERLY RI
02891-2922
US

IV. Provider business mailing address

194 SCAPA FLOW RD
CHARLESTOWN RI
02813-3722
US

V. Phone/Fax

Practice location:
  • Phone: 401-656-4950
  • Fax: 401-348-3734
Mailing address:
  • Phone: 207-460-9705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5841
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA01019
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: