Provider Demographics
NPI:1235529769
Name:DEAN, SARAH M (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:DEAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:M
Other - Last Name:FLICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 SINGLETON RIDGE RD
Mailing Address - Street 2:ATT: PNS CREDENTIALING
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-234-6996
Mailing Address - Fax:843-234-8958
Practice Address - Street 1:2376 CYPRESS CIR, STE 100
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8964
Practice Address - Country:US
Practice Address - Phone:843-234-6888
Practice Address - Fax:843-234-6889
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30838363LA2100X
MI4704339166363L00000X, 363LA2100X
NJ26NJ00551400363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner