Basic Information
Provider Information
NPI: 1477193209
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEADOWCROFT
FirstName: SARAH
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22 S GREENE ST # S10B00
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212011544
CountryCode: US
TelephoneNumber: 4103285840
FaxNumber: 4103280717
Practice Location
Address1: 419 W REDWOOD ST STE 300
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212017003
CountryCode: US
TelephoneNumber: 4103285840
FaxNumber: 4103280717
Other Information
ProviderEnumerationDate: 01/09/2020
LastUpdateDate: 11/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XR213504MDY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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