Individual ProviderSara J. ScrapeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9 Willow Bend Dr, Hattiesburg, MS 39402-8552(601) 296-2552PECOS EnrollmentBased on the most recent information from CMS, provider Sara J. Scrape does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1588615868Provider TypeIndividualFull NameScrape, Sara J.CredentialN.P.GenderFemaleSole ProprietorNoEnumeration Date5/12/2006Last Updated4/27/2011Contact InformationPractice LocationPractice Address9 Willow Bend Dr, Hattiesburg, MS 39402-8552Phone(601) 296-2552Fax(601) 296-2554Mailing LocationMailing Address9 Willow Bend Dr, Hattiesburg, MS 39402-8552Phone(601) 296-2552Fax(601) 296-2554Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR718025MississippiProvider IdentifiersIDDescriptionIssuerID2113445DescriptionMedicaidIssuerUnlistedLouisianaID04385071DescriptionMedicaidIssuerUnlistedMississippiID1180663DescriptionOtherIssuerCIGNAMississippiIDP00791975DescriptionOtherIssuerRAILROAD MEDICAREMississippi