Provider Demographics
NPI:1053631713
Name:HONAKER, SARAH A (FNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:A
Last Name:HONAKER
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 1:5121 MARYLAND WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7516
Mailing Address - Country:US
Mailing Address - Phone:629-206-3254
Mailing Address - Fax:629-216-0568
Practice Address - Street 1:435 2ND ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3703
Practice Address - Country:US
Practice Address - Phone:629-206-3254
Practice Address - Fax:629-216-0568
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00917893OtherRAILROAD MEDICARE
1508879719OtherGROUP NPI
TN103I502527OtherMEDICARE PTAN
TN1520254Medicaid