Provider Demographics
NPI:1467930156
Name:SAPP, LAUREL SHIVER (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:SHIVER
Last Name:SAPP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-9905
Mailing Address - Country:US
Mailing Address - Phone:912-535-9500
Mailing Address - Fax:912-537-8951
Practice Address - Street 1:1608 MEADOWS LN
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474
Practice Address - Country:US
Practice Address - Phone:912-535-9500
Practice Address - Fax:912-537-8951
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN200546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily