Provider Demographics
NPI:1528055894
Name:DONAHUE, SARAH A (APRN)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:A
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:MCLOUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3180 MAIN ST
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4237
Mailing Address - Country:US
Mailing Address - Phone:203-371-7111
Mailing Address - Fax:203-372-5636
Practice Address - Street 1:3180 MAIN ST
Practice Address - Street 2:SUITE G-1
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-4237
Practice Address - Country:US
Practice Address - Phone:203-371-7111
Practice Address - Fax:203-372-5636
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002544363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics