Provider Demographics
NPI:1972378271
Name:MEARS, SARA PAINTER (RN, BSN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:PAINTER
Last Name:MEARS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:HALLWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:23359-0204
Mailing Address - Country:US
Mailing Address - Phone:757-694-5555
Mailing Address - Fax:
Practice Address - Street 1:1532 OCEAN HWY STE 102
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-3023
Practice Address - Country:US
Practice Address - Phone:443-437-7128
Practice Address - Fax:443-437-7131
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001179576163WC0400X, 163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management