Provider Demographics
NPI:1225705072
Name:CHRISTIAN, SARAH REBEKAH (FNP-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:REBEKAH
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-3107
Mailing Address - Country:US
Mailing Address - Phone:662-534-0898
Mailing Address - Fax:662-534-8905
Practice Address - Street 1:119 CITY MARKET DR
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-7002
Practice Address - Country:US
Practice Address - Phone:662-534-0898
Practice Address - Fax:662-534-8905
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS005728097Medicaid