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General NPI Number Information
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NPI Number | 1750462669
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH PROULX RPA-C
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 137 PORTSMOUTH AVE
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City | STRATHAM
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State | NH
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Zip | 03885-2421
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Country | US
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Telephone | 603-775-7444
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Fax |
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Provider Business Mailing Address
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Address Line | 13 EVERGREEN WAY
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City | STRATHAM
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State | NH
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Zip | 03885-2327
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Country | US
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Telephone | 603-580-5608
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 829
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License Number State | NH
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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 | 007907-1
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License Number State | NY
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