Provider Demographics
NPI:1790420123
Name:JETT, SARAH ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:JETT
Suffix:
Gender:F
Credentials:NP-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:835 COGBURN AVENUE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1010
Mailing Address - Country:US
Mailing Address - Phone:770-422-8815
Mailing Address - Fax:770-422-8816
Practice Address - Street 1:2045 HIGHWAY 34 EAST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1325
Practice Address - Country:US
Practice Address - Phone:770-502-0202
Practice Address - Fax:770-502-8822
Is Sole Proprietor?:No
Enumeration Date:2022-04-30
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN270077363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner