MEDICARE: SARAH WEATHERFORD 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	121731	AR

General Provider Information

NPI Number	:	1255987699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH WEATHERFORD APRN

Provider Business Mailing Address
First Line	:	2566 E JOYCE BLVD STE 2
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-3923
Country	:	US
Telephone Number	:	479-935-1000
Fax Number	:	479-935-9200

Provider Business Practice Location Address
First Line	:	2566 E JOYCE BLVD STE 2
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-3923
Country	:	US
Telephone Number	:	479-935-1000
Fax Number	:	479-935-9200

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

Provider Enumeration Date	:	08/12/2019
Last Update Date	:	06/25/2025

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Directions to “ SARAH WEATHERFORD APRN” Practice Location

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