Provider Demographics
NPI:1356004766
Name:DO NASCIMENTO, SARAH WALTERS (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:WALTERS
Last Name:DO NASCIMENTO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:311 BRADFORD CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8096
Mailing Address - Country:US
Mailing Address - Phone:706-830-1900
Mailing Address - Fax:
Practice Address - Street 1:311 BRADFORD CREEK TRL
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8096
Practice Address - Country:US
Practice Address - Phone:706-830-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9091363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant