Provider Demographics
NPI:1396085668
Name:BECKER, SARAH ANN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:BECKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:WESSELMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:618-463-7800
Mailing Address - Fax:618-463-0073
Practice Address - Street 1:5520 GODFREY RD
Practice Address - Street 2:STE B
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-2741
Practice Address - Country:US
Practice Address - Phone:618-463-7800
Practice Address - Fax:618-463-0073
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily