Provider Demographics
NPI:1912744756
Name:YANCEY, SARAH JANE (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:YANCEY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 MALL BLVD APT 120
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4818
Mailing Address - Country:US
Mailing Address - Phone:478-233-3712
Mailing Address - Fax:
Practice Address - Street 1:2321 POOLER PKWY STE 107
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4423
Practice Address - Country:US
Practice Address - Phone:912-303-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13030363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant