Provider Demographics
NPI:1710091160
Name:MYERS, SARAH VIRGINIA (PHD, RN)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:VIRGINIA
Last Name:MYERS
Suffix:
Gender:F
Credentials:PHD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 KINGS WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-2922
Mailing Address - Country:US
Mailing Address - Phone:770-997-7458
Mailing Address - Fax:
Practice Address - Street 1:6419 KINGS WAY
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-2922
Practice Address - Country:US
Practice Address - Phone:770-997-7458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN068905163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology