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General NPI Number Information
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NPI Number | 1306192935
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Entity Type | Individual
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Provider Name | SARA MARISHA SOUKUP NP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 1100 TUNNEL RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-2576
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Country | US
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Telephone | 828-258-1121
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Fax | 828-252-6114
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Provider Business Mailing Address
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Address Line | 1100 TUNNEL RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-2576
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Country | US
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Telephone | 828-298-7911
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Fax | 828-299-2573
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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 | 364SM0705X
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Taxonomy Name | Medical-Surgical Clinical Nurse Specialist
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License Number | 5005691
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5005691
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License Number State | NC
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