Basic Information
| Provider Information | |||||||||
| NPI: | 1588069041 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOOTE | ||||||||
| FirstName: | SARAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9910 FRANKLIN SQUARE DR # 2110 | ||||||||
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| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212364902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109335412 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1132 ANNAPOLIS RD | ||||||||
| Address2: | |||||||||
| City: | ODENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108741600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2014 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | R202720 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.