Provider Demographics
NPI:1205065984
Name:JONES, SARAH LYTTLE (RN, C-PNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYTTLE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN, C-PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 LAKESIDE CENTRE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922
Mailing Address - Country:US
Mailing Address - Phone:865-670-1560
Mailing Address - Fax:865-670-1862
Practice Address - Street 1:2072 LAKESIDE CENTRE WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6591
Practice Address - Country:US
Practice Address - Phone:865-670-1560
Practice Address - Fax:865-670-1862
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14086363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics