Sally Jo Sanford, APRN

Individual provider Active NPI Family Nurse Practitioner · Adairsville, GA

NPI 1720103047 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720103047
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN072580 (GA)
Practice address
14 Legacy Way Ste B
Adairsville, GA 30103-2455
Phone
(770) 773-9902
Fax
(770) 773-9803
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Urology Group, P.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN072580 GA Yes

Addresses

Primary practice location

14 Legacy Way Ste B
Adairsville, GA 30103-2455

Mailing address

276 Little Rd NE
Resaca, GA 30735-6522
Phone (706) 625-7376

Other providers in Adairsville, GA

All providers in Adairsville, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.