MEDICARE: SARAH TEAGUE APRN

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	363LF0000X	Family Nurse Practitioner	122609	AR

General Provider Information

NPI Number	:	1245877794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH TEAGUE APRN

Provider Business Mailing Address
First Line	:	4196 HIGHWAY 62 412 STE A
Second Line	:
City	:	HARDY
State	:	AR
Zip	:	72542-8002
Country	:	US
Telephone Number	:	870-856-1202
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 TAYLOR CIR
Second Line	:
City	:	CAVE CITY
State	:	AR
Zip	:	72521-9137
Country	:	US
Telephone Number	:	870-376-2844
Fax Number	:

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

Provider Enumeration Date	:	12/03/2019
Last Update Date	:	06/28/2024

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Directions to “ SARAH TEAGUE APRN” Practice Location

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