Provider Demographics
NPI:1427699818
Name:WATERS, SARAH (RN, CCRN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WATERS
Suffix:
Gender:F
Credentials:RN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ROSE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-3358
Mailing Address - Country:US
Mailing Address - Phone:912-455-5052
Mailing Address - Fax:
Practice Address - Street 1:333 1ST ST N STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-6939
Practice Address - Country:US
Practice Address - Phone:904-525-8852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN231058163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine