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NPI Code Detail

MEDICARE: SARAH JANE LAGE

MEDICARE: SARAH JANE LAGE
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1902698251
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH JANE LAGE
Provider Business Mailing Address
First Line : CEB 226, 4505 MARYLAND PKWY BOX #453033
Second Line :
City : LAS VEGAS
State : NV
Zip : 89154
Country : US
Telephone Number : 702-895-1532
Fax Number :
Provider Business Practice Location Address
First Line : 801 S RANCHO DR STE D2
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-3807
Country : US
Telephone Number : 702-895-1532
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2025
Last Update Date : 05/21/2025

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Directions to “ SARAH JANE LAGE ” Practice Location

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