Provider Demographics
NPI:1316183478
Name:LOVELACE, SARAH ALICIA (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ALICIA
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ALICIA
Other - Last Name:MAGRISSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 LAKE HEARN DR NE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1523
Mailing Address - Country:US
Mailing Address - Phone:404-252-7339
Mailing Address - Fax:404-257-0337
Practice Address - Street 1:1100 LAKE HEARN DR NE
Practice Address - Street 2:SUITE 450
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1523
Practice Address - Country:US
Practice Address - Phone:404-252-7339
Practice Address - Fax:404-257-0337
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2022-11-03
Deactivation Date:2020-11-30
Deactivation Code:
Reactivation Date:2022-11-01
Provider Licenses
StateLicense IDTaxonomies
GARN177614163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics