Individual
SARA E ALDRIDGE
Active
Individual
SARA E ALDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3004636
KY
363LP0200X
Pediatric Nurse Practitioner
3004636
KY
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
3004636
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300026709
—
IN
01
—
78017415
KY MEDICAID NUMBER
KY
01
—
K001243
KY MEDICARE
KY
Enumeration date
12/19/2005
Last updated
10/12/2020
Update your record
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