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NPI Code Detail

MEDICARE: SARAH ELYSE THORNBURG CRNP

MEDICARE: SARAH ELYSE THORNBURG CRNP
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
1163W00000XRegistered NurseRN637670PA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerSP015312PA

General Provider Information

NPI Number : 1386011716
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELYSE THORNBURG CRNP
Provider Business Mailing Address
First Line : 500 N 13TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-3955
Country : US
Telephone Number : 267-636-6008
Fax Number :
Provider Business Practice Location Address
First Line : 500 N 13TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-3955
Country : US
Telephone Number : 267-636-6008
Fax Number : 800-288-5089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2015
Last Update Date : 03/11/2026

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