Provider Demographics
NPI:1598510141
Name:SAP PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:SAP PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:423-481-9147
Mailing Address - Street 1:905 S SHERBROOKE CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:TN
Mailing Address - Zip Code:37645-4053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 E MAIN ST STE 218
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4257
Practice Address - Country:US
Practice Address - Phone:423-481-9147
Practice Address - Fax:423-616-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty