Provider Demographics
NPI:1528653243
Name:SAUNDERS, JOHN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1719 RUSSELL PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-5765
Mailing Address - Country:US
Mailing Address - Phone:478-328-7674
Mailing Address - Fax:478-328-1393
Practice Address - Street 1:1719 RUSSELL PKWY STE 700
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-5765
Practice Address - Country:US
Practice Address - Phone:478-328-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN135489363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care