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Individual
SARAH J FAXON
Active
Individual
SARAH J FAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3011935
KY
363L00000X
Nurse Practitioner
71009550A
IN
363LF0000X
Family Nurse Practitioner
3011935
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114527
RN LICENSE
KY
01
—
28254500A
RN LICENSE
IN
01
—
3011935
APRN LICENSE
KY
01
—
71009550A
APRN LICENSE
IN
01
—
F11170196
AANP CERTIFICATION NUMBER
—
Enumeration date
07/30/2019
Last updated
08/18/2020
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