Provider Demographics
NPI:1932566387
Name:EDWARDS, SARA MITCHELL (CNM, MN, MPH)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MITCHELL
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CNM, MN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 CONNEMARA TRCE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4843
Mailing Address - Country:US
Mailing Address - Phone:770-313-8901
Mailing Address - Fax:
Practice Address - Street 1:80 JESSE HILL JR DRIVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-616-1000
Practice Address - Fax:404-616-2904
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN105259163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient