Provider Demographics
NPI:1033474242
Name:DAVIS, SARAH KELLEY (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:KELLEY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 SUTTONWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7173
Mailing Address - Country:US
Mailing Address - Phone:770-932-7597
Mailing Address - Fax:
Practice Address - Street 1:1500 OGLETHORPE AVE
Practice Address - Street 2:SUITE 200C
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2179
Practice Address - Country:US
Practice Address - Phone:706-549-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN191859363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health