Provider Demographics
NPI:1992376115
Name:WARD, SARA E (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:WARD
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 1:54 EXETER RD
Mailing Address - Street 2:STE B
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1985
Mailing Address - Country:US
Mailing Address - Phone:731-265-6197
Mailing Address - Fax:731-265-6198
Practice Address - Street 1:54 EXETER RD STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1985
Practice Address - Country:US
Practice Address - Phone:731-265-6197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily