Provider Demographics
NPI:1124265756
Name:WHITTINGTON, SARAH PETERSEN (CNM)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:PETERSEN
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4351 E LOHMAN AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8263
Mailing Address - Country:US
Mailing Address - Phone:575-556-3252
Mailing Address - Fax:575-521-6218
Practice Address - Street 1:4351 E LOHMAN AVE STE 408
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8263
Practice Address - Country:US
Practice Address - Phone:575-556-3252
Practice Address - Fax:575-521-6218
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0003301-C-CNM367A00000X
NM618367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM68809352Medicaid