Basic Information
Provider Information
NPI: 1689345860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHALEN
FirstName: SARAH
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 207 S MAIN ST
Address2:  
City: NEWMARKET
State: NH
PostalCode: 038571835
CountryCode: US
TelephoneNumber: 6036593106
FaxNumber: 6036595892
Practice Location
Address1: 207 S MAIN ST
Address2:  
City: NEWMARKET
State: NH
PostalCode: 038571835
CountryCode: US
TelephoneNumber: 6032927292
FaxNumber: 6036593106
Other Information
ProviderEnumerationDate: 09/27/2021
LastUpdateDate: 09/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X075313-23NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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