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Individual
SARAH HOURSELT
Active
Individual
SARAH HOURSELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-008193
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041309293
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147240
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
CA4748
MEDICARE RAILROAD (GROUP)
IL
01
—
P01258415
MEDICARE RAILROAD (INDIVIDUAL)
IL
Enumeration date
08/13/2010
Last updated
03/17/2018
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