Provider Demographics
NPI:1649443508
Name:DAVIS, SARAH (APRN)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7892
Mailing Address - Country:US
Mailing Address - Phone:802-864-6935
Mailing Address - Fax:
Practice Address - Street 1:185 TILLEY DR STE 52
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-4484
Practice Address - Country:US
Practice Address - Phone:802-881-1855
Practice Address - Fax:866-645-9876
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010017875363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health