Provider Demographics
NPI:1710313481
Name:YON, SARAH MARIE (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:YON
Suffix:
Gender:F
Credentials:NP
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 12330
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-2330
Mailing Address - Country:US
Mailing Address - Phone:706-863-9595
Mailing Address - Fax:706-447-7179
Practice Address - Street 1:601 E HAMPDEN AVE STE 310
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2769
Practice Address - Country:US
Practice Address - Phone:706-863-9595
Practice Address - Fax:706-868-8375
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992371-NP363LF0000X, 363LF0000X
IL209011568363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147OtherMEDICARE PTAN (GROUP)
ILF400197239OtherMEDICARE PTAN (INDIVIDUAL)
ILF400197239OtherMEDICARE PTAN (INDIVIDUAL)