Individual
SARAH ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
3750 LANDMARK DR STE B, LAFAYETTE, IN 47905-6652
(765) 448-8000
Mailing address
3750 LANDMARK DR STE B, LAFAYETTE, IN 47905-6652
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
28210194A
IN
Other
Enumeration date
11/14/2019
Last updated
02/19/2021
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