Provider Demographics
NPI:1427472422
Name:KINNEY, SARA (FNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KINNEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8385 DIVISION RD
Mailing Address - Street 2:
Mailing Address - City:WHITE CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97503-1176
Mailing Address - Country:US
Mailing Address - Phone:541-826-5853
Mailing Address - Fax:541-826-5843
Practice Address - Street 1:8385 DIVISION RD
Practice Address - Street 2:
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503-1176
Practice Address - Country:US
Practice Address - Phone:541-826-5853
Practice Address - Fax:541-826-5843
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY673506-1163WH0200X
OR201501105NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health