Provider Demographics
NPI:1114342839
Name:JASPER, SARA FRANCES (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:FRANCES
Last Name:JASPER
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:FRANCES
Other - Last Name:BEACHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9228 MEDICAL PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9125
Mailing Address - Country:US
Mailing Address - Phone:843-574-5693
Mailing Address - Fax:843-764-4512
Practice Address - Street 1:9228 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9125
Practice Address - Country:US
Practice Address - Phone:843-574-5693
Practice Address - Fax:843-764-4512
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY664365-1163WC0200X
NYF430887363LA2100X
SC22260363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care