Provider Demographics
NPI:1710756259
Name:JONES, SARA ETHRIDGE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ETHRIDGE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 HOUSTON NORTHCUTT BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3488
Mailing Address - Country:US
Mailing Address - Phone:803-331-7594
Mailing Address - Fax:
Practice Address - Street 1:976 HOUSTON NORTHCUTT BLVD STE H
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3488
Practice Address - Country:US
Practice Address - Phone:843-951-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily