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Individual
MRS. SARAH BETH MCQUEEN
Active
Individual
MRS. SARAH BETH MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1157
KY
363A00000X
Physician Assistant
1638
TN
363A00000X
Physician Assistant
TC043
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297025
KY MEDICARE
KY
01
—
1157
STATE LICENSE
KY
05
—
1511676
—
TN
01
—
1638
STATE LICENSE
TN
01
—
3665298
TN MEDICARE
TN
01
—
36652981
TN MEDICARE
TN
05
—
7100180060
—
KY
Enumeration date
08/25/2008
Last updated
03/07/2023
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