Provider Demographics
NPI:1619345360
Name:SADLER, LORI ALLEN (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ALLEN
Last Name:SADLER
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 EPPS BRIDGE RD
Mailing Address - Street 2:UNIT 8D
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-8381
Mailing Address - Country:US
Mailing Address - Phone:706-957-0860
Mailing Address - Fax:
Practice Address - Street 1:517 GREAT OAKS DR
Practice Address - Street 2:SUITE #103
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-8211
Practice Address - Country:US
Practice Address - Phone:770-207-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186975363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics