Provider Demographics
NPI:1043768054
Name:CHICHESTER, SARAH JULIANA (PMHNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JULIANA
Last Name:CHICHESTER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3287 RACQUET CLUB DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4702
Mailing Address - Country:US
Mailing Address - Phone:231-935-0355
Mailing Address - Fax:
Practice Address - Street 1:3287 RACQUET CLUB DR UNIT A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4702
Practice Address - Country:US
Practice Address - Phone:231-935-0355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704304518363LP0808X
CA95080334163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse