Provider Demographics
NPI:1962572875
Name:WILLIAMS, SARA L (FNP C)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:L
Last Name:WILLIAMS
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Gender:F
Credentials:FNP C
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Mailing Address - Street 1:220 J L WHITE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-4893
Mailing Address - Country:US
Mailing Address - Phone:706-636-6500
Mailing Address - Fax:706-636-6502
Practice Address - Street 1:220 J L WHITE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-4893
Practice Address - Country:US
Practice Address - Phone:706-253-8001
Practice Address - Fax:706-253-8002
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2011-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN189268 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003106096AMedicaid
GA202I509904Medicare UPIN