MEDICARE: SARAH ROMERO FNP

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	AP08108	LA

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	:	1265821326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ROMERO FNP

Provider Business Mailing Address
First Line	:	PO BOX 4176
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70361-4176
Country	:	US
Telephone Number	:	985-872-5864
Fax Number	:	985-872-0317

Provider Business Practice Location Address
First Line	:	1231 DAVID DR
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-1321
Country	:	US
Telephone Number	:	985-385-6390
Fax Number	:	985-385-6393

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

Provider Enumeration Date	:	01/13/2015
Last Update Date	:	05/11/2015

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