Provider Demographics
NPI:1447086707
Name:GILL, SARAH (PMHNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GILL
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 1:1507 S FRANKLIN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167-7590
Mailing Address - Country:US
Mailing Address - Phone:812-620-6141
Mailing Address - Fax:
Practice Address - Street 1:1321 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-9730
Practice Address - Country:US
Practice Address - Phone:812-883-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015733A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health