Provider Demographics
NPI:1043770738
Name:RED, SARA-PAGE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA-PAGE
Middle Name:
Last Name:RED
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 GLENWOOD DR STE E790
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1178
Mailing Address - Country:US
Mailing Address - Phone:423-206-4140
Mailing Address - Fax:423-206-4141
Practice Address - Street 1:HOSPITALIST / NEUROSCIENCE
Practice Address - Street 2:2525 DESALES AVENUE
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-495-2525
Practice Address - Fax:423-495-2625
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN276352363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN276352OtherRN