Provider Demographics
NPI:1215398128
Name:ABERCROMBIE, SARA ELAINE (CNM)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELAINE
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:GEPHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:PO BOX 947407
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-7407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:1700 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3509
Practice Address - Country:US
Practice Address - Phone:941-917-8560
Practice Address - Fax:941-917-2675
Is Sole Proprietor?:No
Enumeration Date:2016-03-19
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019002363LW0102X, 367A00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health