Provider Demographics
NPI:1003057167
Name:JONES, SARA A (ANP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:A
Other - Last Name:FREDERICKSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 440509
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0509
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:1926 ALCOA HWY STE 410
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1545
Practice Address - Country:US
Practice Address - Phone:865-305-8780
Practice Address - Fax:865-305-8199
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13961363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514121Medicaid
TN1514121Medicaid