Provider Demographics
NPI:1215624648
Name:KILGORE, SARAH E (RN)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:E
Last Name:KILGORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 VESTAVIA FOREST TER
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2625
Mailing Address - Country:US
Mailing Address - Phone:205-568-1525
Mailing Address - Fax:
Practice Address - Street 1:2613 VESTAVIA FOREST TER
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-2625
Practice Address - Country:US
Practice Address - Phone:205-568-1525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143526163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse