Provider Demographics
NPI:1619669231
Name:THURMON, SARAH R (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:THURMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306415
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6415
Mailing Address - Country:US
Mailing Address - Phone:931-253-1110
Mailing Address - Fax:931-253-1190
Practice Address - Street 1:2121 GRAND AVE
Practice Address - Street 2:
Practice Address - City:YAZOO CITY
Practice Address - State:MS
Practice Address - Zip Code:39194-2312
Practice Address - Country:US
Practice Address - Phone:662-716-8071
Practice Address - Fax:662-716-8072
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily