Provider Demographics
NPI:1003676776
Name:KAFADER, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KAFADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-4173
Mailing Address - Country:US
Mailing Address - Phone:401-996-1634
Mailing Address - Fax:
Practice Address - Street 1:620 TIMBER RIDGE DR
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-4173
Practice Address - Country:US
Practice Address - Phone:401-996-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2023-04374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula