Healthcare Provider Details

I. General information

NPI: 1245160787
Provider Name (Legal Business Name): SARAH LEYERLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 CHERRY AVE
MC KENZIE TN
38201-1769
US

IV. Provider business mailing address

2925 GREENWAY CREEK VW APT 213
COLORADO SPRINGS CO
80922-3476
US

V. Phone/Fax

Practice location:
  • Phone: 731-325-4000
  • Fax:
Mailing address:
  • Phone: 719-339-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: