Doctor Name: | MRS. SARAH DUBOSE |
NPI Number: | 1083072219 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | AP130187 |
Business Practice Address: | 2501 Jimmy Johnson Blvd Ste 405 Port Arthur, TX - 776402013 |
Business Phone Number: | 4097226553 |
Business Fax Number: | 4097221885 |
Mailing Address: | 2501 Jimmy Johnson Blvd Ste 405, PORT ARTHUR |
State: | TX |
Postal Code: | 776402013 |
Phone Number: | 4097226553 |
Fax Number: | 4097221885 |
NPI Enumeration Date: | 02/02/2016 |
NPI Last Update Date: | 02/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP130187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |