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General NPI Number Information
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NPI Number | 1487029666
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Entity Type | Individual
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Provider Name | SARAH AMILY SEPULVEDA FARRAR FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 04/24/2016
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Provider Practice Location Address
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Address Line | 909 SOUTHEAST PKWY
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City | AZLE
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State | TX
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Zip | 76020-3693
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Country | US
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Telephone | 817-334-6525
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Fax |
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Provider Business Mailing Address
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Address Line | 139 CREEKWOOD RANCH RD
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City | AZLE
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State | TX
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Zip | 76020-8045
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Country | US
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Telephone | 817-903-1110
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 779014
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License Number State | TX
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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 | AP129770
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License Number State | TX
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