Provider Demographics
NPI:1427386028
Name:MATHIS, SARAH N (NP)
Entity type:Individual
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First Name:SARAH
Middle Name:N
Last Name:MATHIS
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Gender:F
Credentials:NP
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Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-424-6893
Mailing Address - Fax:770-528-9938
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 350
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-424-6893
Practice Address - Fax:770-528-9938
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2012-06-20
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Provider Licenses
StateLicense IDTaxonomies
GARN170479363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA119107548AMedicaid
GA119107548BMedicaid
GA119107548CMedicaid
GA119107548BMedicaid