Provider Demographics
NPI:1487125043
Name:PLANTE-OLIVAS, SARAH (FNP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PLANTE-OLIVAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 S TELSHOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-5130
Mailing Address - Country:US
Mailing Address - Phone:575-556-5914
Mailing Address - Fax:575-556-6297
Practice Address - Street 1:2540 S TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5130
Practice Address - Country:US
Practice Address - Phone:575-556-5914
Practice Address - Fax:575-556-6297
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-07
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM54504363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily