Provider Demographics
NPI:1548468465
Name:DAME, SARA ANNE (LPN)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ANNE
Last Name:DAME
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:19148 258TH
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-0000
Mailing Address - Country:US
Mailing Address - Phone:913-367-4583
Mailing Address - Fax:
Practice Address - Street 1:505 POPE
Practice Address - Street 2:
Practice Address - City:FT. LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-0000
Practice Address - Country:US
Practice Address - Phone:913-684-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-29615-105164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse