| NPI | 1467957860 |
|---|---|
| Former Name | SARAH ROSE LOGAN |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5378102) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-78102-102) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: KS 53-78102-102) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2021-08-23 |