MEDICARE: SARAH OLIVIA MENOTTI NP

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	363LW0102X	Women's Health Nurse Practitioner	AP143112	TX

General Provider Information

NPI Number	:	1801436340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH OLIVIA MENOTTI NP

Provider Business Mailing Address
First Line	:	5510 LANIS ST
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-3800
Country	:	US
Telephone Number	:	713-725-2683
Fax Number	:

Provider Business Practice Location Address
First Line	:	3828 HUGHES CT STE 104
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-6235
Country	:	US
Telephone Number	:	409-266-1888
Fax Number	:

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

Provider Enumeration Date	:	01/13/2020
Last Update Date	:	01/13/2020

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