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SARAH PRESIDENT F1116456

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1912434168

Individual Registrant:
 SARAH  PRESIDENT F1116456
Gender: F
Sole Proprietor

Location and contact information for practice:
431 SAGE ST  TEMPLE, GA 30179-3726 US
Tel: 770-562-9007  Fax: 770-562-9060

Contact information for business:
2629 HILDERBRAND DR  DOUGLASVILLE, GA 30135-5135 US
Tel: 770-616-7758  Fax: 770-562-9060

Registration Information:
NPI: 1912434168
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
GAF1116456

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
NURSE PRACTITIONERS CERTIFICATION PROGRAMF1116456GA01




HEALTH CARE JOBS GA - Page 1



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