Provider Demographics
NPI:1417346156
Name:DARDEN, SARA MULLINAX (MMSC, PA-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MULLINAX
Last Name:DARDEN
Suffix:
Gender:F
Credentials:MMSC, PA-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:MULLINAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MMSC, PA-C
Mailing Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8029
Mailing Address - Country:US
Mailing Address - Phone:770-721-9050
Mailing Address - Fax:770-721-9051
Practice Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 160
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8029
Practice Address - Country:US
Practice Address - Phone:770-721-9050
Practice Address - Fax:770-721-9051
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4761363A00000X, 363AS0400X
GA12062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical