Provider Demographics
NPI:1699478974
Name:CROOKE, SARAH SHEHADI (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:SHEHADI
Last Name:CROOKE
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MAIN ST UNIT 235
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-9998
Mailing Address - Country:US
Mailing Address - Phone:850-475-2668
Mailing Address - Fax:850-475-2669
Practice Address - Street 1:150 E REDSTONE AVE STE A
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5322
Practice Address - Country:US
Practice Address - Phone:504-752-6688
Practice Address - Fax:850-475-2669
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily