Provider Demographics
NPI:1346899135
Name:DAVIS, SARAH K (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:K
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 NE STALLINGS DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1608
Mailing Address - Country:US
Mailing Address - Phone:936-559-8770
Mailing Address - Fax:936-559-8770
Practice Address - Street 1:4604 NE STALLINGS DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1608
Practice Address - Country:US
Practice Address - Phone:936-559-8770
Practice Address - Fax:936-559-8770
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF09190163363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner