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General NPI Number Information
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NPI Number | 1619801180
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Entity Type | Individual
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Provider Name | SARA COUSSENS RN
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Gender | Female
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 15740 S OUTER 40 RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2004
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Country | US
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Telephone | 636-735-4930
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Fax | 636-735-4930
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Provider Business Mailing Address
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Address Line | 1402 N SMILEY ST
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City | O FALLON
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State | IL
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Zip | 62269-6755
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Country | US
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Telephone |
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 041453006
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 2010026815
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License Number State | MO
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