| Doctor Name: | SARAH WALLACE EISWORTH |
| NPI Number: | 1225393283 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 06938 |
| Business Practice Address: | 19900 Old Scenic Hwy Zachary, LA - 707917368 |
| Business Phone Number: | 2255702618 |
| Business Fax Number: | 2255708539 |
| Mailing Address: | 17304 Chickasaw Ave, GREENWELL SPRINGS |
| State: | LA |
| Postal Code: | 707396119 |
| Phone Number: | 9855170597 |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2012 |
| NPI Last Update Date: | 02/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 06938 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |