Provider Demographics
NPI:1659998722
Name:ACOSTA, AMABEL SARMIENTO (RN,APRN-NP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMABEL
Middle Name:SARMIENTO
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:RN,APRN-NP, PMHNP-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 MILLERS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7791
Mailing Address - Country:US
Mailing Address - Phone:480-352-3714
Mailing Address - Fax:
Practice Address - Street 1:250 BRAY STREET
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-2244
Practice Address - Country:US
Practice Address - Phone:706-612-6995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN256895163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse