Provider Demographics
NPI:1902341308
Name:FLETCHER, SARAH MACLOVIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MACLOVIA
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 QUILEUTE HEIGHTS
Mailing Address - Street 2:
Mailing Address - City:LA PUSH
Mailing Address - State:WA
Mailing Address - Zip Code:98350
Mailing Address - Country:US
Mailing Address - Phone:360-374-7764
Mailing Address - Fax:360-374-2644
Practice Address - Street 1:QUILEUTE HEALTH CENTER
Practice Address - Street 2:560 QUILEUTE HEIGHTS
Practice Address - City:LA PUSH
Practice Address - State:WA
Practice Address - Zip Code:98350
Practice Address - Country:US
Practice Address - Phone:360-374-9035
Practice Address - Fax:360-374-2644
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60285107163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse