Provider Demographics
NPI:1205435203
Name:NEO WOMEN'S HEALTH
Entity type:Organization
Organization Name:NEO WOMEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WOMEN'S HEALTH NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAPP
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:719-641-6405
Mailing Address - Street 1:230 GUSTAV CT
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8212
Mailing Address - Country:US
Mailing Address - Phone:719-641-6405
Mailing Address - Fax:
Practice Address - Street 1:3707 KING RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-2352
Practice Address - Country:US
Practice Address - Phone:706-785-0515
Practice Address - Fax:706-785-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatalGroup - Single Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty