Provider Demographics
NPI:1578391710
Name:SCAGGS, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SCAGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 NICHOLASVILLE RD STE 502
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1473
Mailing Address - Country:US
Mailing Address - Phone:859-639-0920
Mailing Address - Fax:859-639-0921
Practice Address - Street 1:1760 NICHOLASVILLE RD STE 502
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1473
Practice Address - Country:US
Practice Address - Phone:859-639-0920
Practice Address - Fax:859-639-0921
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4024487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily