Provider Demographics
NPI:1538100847
Name:GEORGE, SARAH M (MSN, APRN,BC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:M
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MSN, APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 SW RAMSEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527
Mailing Address - Country:US
Mailing Address - Phone:541-472-5501
Mailing Address - Fax:541-472-5671
Practice Address - Street 1:10 OAK FOREST RD
Practice Address - Street 2:SUITE C
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4973
Practice Address - Country:US
Practice Address - Phone:843-805-3006
Practice Address - Fax:843-815-3737
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201504879NP-PP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1143Medicaid
SCNP1143Medicaid
SCP593427416Medicare PIN
SCP00398843Medicare PIN