Provider Demographics
NPI:1639950256
Name:NAVARRA, SARAH ROSE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ROSE
Last Name:NAVARRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 S MAIN ST NW APT 164
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2741
Mailing Address - Country:US
Mailing Address - Phone:484-884-5278
Mailing Address - Fax:
Practice Address - Street 1:3240 N E EXPY NE
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-4003
Practice Address - Country:US
Practice Address - Phone:404-480-9339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11948363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant