MEDICARE: SARAH DANIELLE BIRD

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1518829050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DANIELLE BIRD

Provider Business Mailing Address
First Line	:	PO BOX 911
Second Line	:
City	:	EL PRADO
State	:	NM
Zip	:	87529-0911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 STATE HIGHWAY 522 # 6
Second Line	:
City	:	EL PRADO
State	:	NM
Zip	:	87529-6051
Country	:	US
Telephone Number	:	575-999-5487
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ SARAH DANIELLE BIRD ” Practice Location

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