Individual
SALLY SARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-6511
Mailing address
1730 S. MAXWELL ST., BLOOMINGTON, IN 47401-6627
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71001843
IN
Other
Enumeration date
08/09/2006
Last updated
10/08/2007
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