Provider Demographics
NPI:1902055213
Name:ROSENBAUM, SARA J (APN, CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:APN, CNM, WHNP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:J
Other - Last Name:LEEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 25317
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5317
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:1411 S 14TH ST STE D
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-3092
Practice Address - Country:US
Practice Address - Phone:904-321-0064
Practice Address - Fax:904-491-3113
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000621367A00000X, 363LX0001X
IL209.007249363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology