Provider Demographics
NPI:1609469378
Name:LEGASSIE, SARAH CLIPSE (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CLIPSE
Last Name:LEGASSIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2436
Mailing Address - Country:US
Mailing Address - Phone:423-863-4182
Mailing Address - Fax:
Practice Address - Street 1:805 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2436
Practice Address - Country:US
Practice Address - Phone:423-863-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-14
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN167788163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant