Provider Demographics
NPI:1063220341
Name:GULLETT, SARAH (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GULLETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MANCINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:515 VALLEY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-4300
Mailing Address - Country:US
Mailing Address - Phone:908-663-2929
Mailing Address - Fax:
Practice Address - Street 1:515 VALLEY ST STE 203
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-4300
Practice Address - Country:US
Practice Address - Phone:908-663-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR216507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse