Provider Demographics
NPI:1821547217
Name:HUGHLEY, SARA JESSICA (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JESSICA
Last Name:HUGHLEY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JESSICA
Other - Last Name:RAWLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP-BC
Mailing Address - Street 1:PO BOX 100277
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0277
Mailing Address - Country:US
Mailing Address - Phone:352-294-5481
Mailing Address - Fax:352-392-6481
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1920
Practice Address - Country:US
Practice Address - Phone:352-294-5481
Practice Address - Fax:352-392-6481
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-142441363LA2100X
FLAPRN11001238363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104966500Medicaid