Provider Demographics
NPI:1710389903
Name:RANSOM, SARAH ANNETTE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANNETTE
Last Name:RANSOM
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNETTE
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3005 AMBROSE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-4709
Mailing Address - Country:US
Mailing Address - Phone:844-673-6968
Mailing Address - Fax:844-673-6968
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-4392
Practice Address - Country:US
Practice Address - Phone:352-265-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003173157AMedicaid
FL014699600Medicaid
FLP01616300Medicare PIN
FLIC727YMedicare PIN