MEDICARE: SARA ELIZABETH HALE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1005541	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134744410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELIZABETH HALE

Provider Business Mailing Address
First Line	:	323 E HAWKINS PKWY
Second Line	:	STE A
City	:	LONGVIEW
State	:	TX
Zip	:	75605-8162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	323 E HAWKINS PKWY
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75605-8153
Country	:	US
Telephone Number	:	903-758-2746
Fax Number	:	903-758-7127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2020
Last Update Date	:	01/04/2024

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Directions to “ SARA ELIZABETH HALE ” Practice Location

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