Provider Demographics
NPI:1497757397
Name:SAWYER, ONDRIA M (ND/NURSE PRACTITIONE)
Entity Type:Individual
Prefix:DR
First Name:ONDRIA
Middle Name:M
Last Name:SAWYER
Suffix:
Gender:F
Credentials:ND/NURSE PRACTITIONE
Other - Prefix:
Other - First Name:ONDRIA
Other - Middle Name:M
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-4855
Mailing Address - Fax:
Practice Address - Street 1:140 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9260
Practice Address - Country:US
Practice Address - Phone:843-234-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 36363LA2100X, 363LP0200X
NC5009650363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP47390Medicare UPIN