Provider Demographics
NPI:1780343533
Name:MURTHA, SARAH MAE (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MAE
Last Name:MURTHA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MAE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:
Practice Address - Street 1:1112 S LAKE AVE
Practice Address - Street 2:STE 201
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57117-1300
Practice Address - Country:US
Practice Address - Phone:605-312-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1350363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant