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General NPI Number Information
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NPI Number | 1093512444
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Entity Type | Individual
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Provider Name | SARAH JANE ULRICH FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 401 N MAIN ST
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City | ROANOKE
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State | IL
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Zip | 61561-7585
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Country | US
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Telephone | 309-923-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 81 ALLENDALE
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4751
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Country | US
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Telephone | 812-236-1361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.031738
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 38049
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License Number State | TN
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