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General NPI Number Information
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NPI Number | 1245877794
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Entity Type | Individual
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Provider Name | SARAH TEAGUE APRN
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Gender | Female
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 444 TAYLOR CIR
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City | CAVE CITY
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State | AR
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Zip | 72521-9137
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Country | US
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Telephone | 870-376-2844
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Fax |
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Provider Business Mailing Address
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Address Line | 4196 HIGHWAY 62 412 STE A
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City | HARDY
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State | AR
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Zip | 72542-8002
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Country | US
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Telephone | 870-856-1202
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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 | 122609
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License Number State | AR
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