Provider Demographics
NPI:1386237519
Name:COLLINS, SARAH L
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5516
Mailing Address - Country:US
Mailing Address - Phone:724-531-5567
Mailing Address - Fax:724-206-6632
Practice Address - Street 1:575 FAYETTE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5516
Practice Address - Country:US
Practice Address - Phone:724-531-5567
Practice Address - Fax:724-206-6632
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10005357376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA852292987OtherHOME CARE AGENCY