| Doctor Name: | SARA BOTCHLET |
| NPI Number: | 1285919753 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 86177 |
| Business Practice Address: | 14890 Se 29th St Suite 106 Choctaw, OK - 730203515 |
| Business Phone Number: | 4056200049 |
| Business Fax Number: | 4052815726 |
| Mailing Address: | 14890 Se 29th St, Suite 106 CHOCTAW |
| State: | OK |
| Postal Code: | 730203515 |
| Phone Number: | 4056200049 |
| Fax Number: | 4052815726 |
| NPI Enumeration Date: | 10/17/2011 |
| NPI Last Update Date: | 09/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 86177 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |