Provider Demographics
NPI:1073372702
Name:DARMADJI, SARA M (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:M
Last Name:DARMADJI
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:859-744-1177
Practice Address - Street 1:1850 BYPASS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2300
Practice Address - Country:US
Practice Address - Phone:859-744-5111
Practice Address - Fax:859-744-1177
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily