Sara Jane Adair, RN,BSN
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Gautier, MS
NPI 1013545128 · NPPES record last updated Apr 1, 2020
Key facts
- NPI
- 1013545128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- R864450 (MS)
- Practice address
- 330B Highway 90
Gautier, MS 39553-5744 - Phone
- (228) 497-0434
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R864450 | MS | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | R864450 | MS | Yes |
Addresses
Primary practice location
330B Highway 90
Gautier, MS 39553-5744
Mailing address
14812 Nassau Dr
Biloxi, MS 39532-5713
Phone (228) 697-6238
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018214 | Medicaid | MS |
Other providers in Gautier, MS
All providers in Gautier, MS · Psychiatric/Mental Health Registered Nurse in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.