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NPI Code Detail

MEDICARE: SARAH NEMBU FNP

MEDICARE:   SARAH  NEMBU  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
1363LF0000XFamily Nurse Practitioner699562TX
2363LF0000XFamily Nurse PractitionerAP118966TX
3363LP0222XCritical Care Pediatric Nurse PractitionerAP118966TX

General Provider Information

NPI Number : 1609167014
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH NEMBU FNP
Provider Business Mailing Address
First Line : PO BOX 733784
Second Line :
City : DALLAS
State : TX
Zip : 75373-3784
Country : US
Telephone Number : 682-885-1855
Fax Number : 682-885-1396
Provider Business Practice Location Address
First Line : 10601 N RIVERSIDE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-2118
Country : US
Telephone Number : 817-347-4600
Fax Number : 817-347-4639
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2011
Last Update Date : 05/05/2021

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