Provider Demographics
NPI:1063466910
Name:KESSEN, SARAH E (MSN, ANP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:KESSEN
Suffix:
Gender:F
Credentials:MSN, ANP
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:EHLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ANP
Mailing Address - Street 1:12813 FLUSHING MEADOWS DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-966-0111
Mailing Address - Fax:314-966-1023
Practice Address - Street 1:12855 NORTH FORTY DRIVE
Practice Address - Street 2:SUITE 125
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-966-0111
Practice Address - Fax:314-966-1023
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO127828363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO151725OtherBCBS
MOP00603957OtherMEDICARE RAILROAD
MO000080957OtherMEDICARE
MO466634OtherHEALTHLINK
MOP00603957OtherMEDICARE RAILROAD
MO0162570001Medicare NSC