Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sara Coburn

Individual provider Registered Nurse · NPI 1861115750

Sara Coburn is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2004, 22 years ago. Practices with Park Center Inc, a 47-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
22
Licensed in
IN
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

909 E State Blvd
Fort Wayne, IN 46805-3404
Phone: (260) 481-2700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71013113A (IN)
Registered Nurse Taxonomy 163W00000X · Licence 28160949A (IN)

Record details

NPI number1861115750
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 26, 2022
Last updated in NPPESMarch 23, 2023
Certification dateMarch 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Park Center Inc — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fort Wayne