Basic Information
| Provider Information | |||||||||
| NPI: | 1083126171 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AURICH | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | GRACE FOX | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8007 | ||||||||
| Address2: | |||||||||
| City: | MOSCOW | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838430507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2088832224 | ||||||||
| FaxNumber: | 2088836580 | ||||||||
| Practice Location | |||||||||
| Address1: | 606 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | KENDRICK | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082893841 | ||||||||
| FaxNumber: | 2082893961 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2017 | ||||||||
| LastUpdateDate: | 05/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 72077 | ID | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 72077 | ID | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.