Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP130061 | TX |
NPI | 1003274291 |
---|---|
Provider Name | Sarah Faye Earnest |
First Address | Longview, TX 75606 |
Second Address | Longview, TX 75601-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2016 |
Last Update Date | 18/07/2016 |