Provider Demographics
NPI:1033507116
Name:BENNETT, SARAH RENEE (CRNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:RANGELOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5400 PREAKNESS WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5880
Mailing Address - Country:US
Mailing Address - Phone:410-469-4680
Mailing Address - Fax:
Practice Address - Street 1:5400 PREAKNESS WAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5880
Practice Address - Country:US
Practice Address - Phone:410-469-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-25
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186722363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics