Sarah Carson

Individual provider Active NPI Clinical Nurse Specialist · La Fayette, GA

NPI 1194100362 · NPPES record last updated Jul 29, 2015

Key facts

NPI
1194100362
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Nurse Specialist 364S00000X
License
LPN090474 (GA)
Practice address
3949 Round Pond Rd
La Fayette, GA 30728-4710
Phone
(423) 314-1252
NPI assigned
Jul 29, 2015
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

State licenses

LicenseStateTypeSpecialty
LPN090474GAMDClinical Nurse Specialist
86290TNMDClinical Nurse Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X LPN090474 GA Yes
Clinical Nurse Specialist 364S00000X 86290 TN

Addresses

Primary practice location

3949 Round Pond Rd
La Fayette, GA 30728-4710

Mailing address

3949 Round Pond Rd
La Fayette, GA 30728-4710
Phone (423) 314-1252

Other providers in La Fayette, GA

All providers in La Fayette, GA · Clinical Nurse Specialist in Georgia

Sources for this page

Verify at the official NPI Registry.