Provider Demographics
NPI:1053043372
Name:GREEN, SARAH TALBOTT (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:TALBOTT
Last Name:GREEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22024 RHEA COUNTY HWY
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37381-5243
Mailing Address - Country:US
Mailing Address - Phone:423-299-1390
Mailing Address - Fax:
Practice Address - Street 1:22024 RHEA COUNTY HWY
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:TN
Practice Address - Zip Code:37381-5243
Practice Address - Country:US
Practice Address - Phone:423-299-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN209324363LF0000X
TN31963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily