Provider Demographics
NPI:1033092457
Name:WOOTAN, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WOOTAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3878 HIGHWAY 281 UNIT 548
Mailing Address - Street 2:
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-3907
Mailing Address - Country:US
Mailing Address - Phone:701-472-2542
Mailing Address - Fax:
Practice Address - Street 1:3878 HIGHWAY 281 UNIT 548
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-3907
Practice Address - Country:US
Practice Address - Phone:701-472-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician