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General NPI Number Information
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NPI Number | 1558633198
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Entity Type | Individual
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Provider Name | SARA CAROLINE PASSEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/28/2012
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 4125 LAWNDALE DR
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City | GREENSBORO
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State | NC
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Zip | 27455-1885
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Country | US
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Telephone | 336-543-0786
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Fax | 336-234-5411
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Provider Business Mailing Address
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Address Line | 4125 LAWNDALE DR
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City | GREENSBORO
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State | NC
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Zip | 27455-1885
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Country | US
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Telephone | 336-543-0786
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Fax | 336-234-5411
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60421565
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-13414
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 016923
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License Number State | NY
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