Provider Demographics
NPI:1639411796
Name:OWENS, SARAH ANNE (CNM)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNE
Last Name:OWENS
Suffix:
Gender:F
Credentials:CNM
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 1170
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-1170
Mailing Address - Country:US
Mailing Address - Phone:470-325-0100
Mailing Address - Fax:
Practice Address - Street 1:1942 ATKINSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5003
Practice Address - Country:US
Practice Address - Phone:678-775-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205966367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCMW0215Medicaid
GA003135301AMedicaid
SCMW0215Medicaid