Provider Demographics
NPI:1639508203
Name:NELLER, SARAH (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NELLER
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BILTMORE DR APT A
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4123
Mailing Address - Country:US
Mailing Address - Phone:214-906-0240
Mailing Address - Fax:
Practice Address - Street 1:319 BROAD ST
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:TN
Practice Address - Zip Code:38544-5117
Practice Address - Country:US
Practice Address - Phone:931-858-2116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18107363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health