Provider Demographics
NPI:1336556653
Name:SAYERS, CARLY WHAM (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:WHAM
Last Name:SAYERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:ELIZABETH
Other - Last Name:WHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:340 N MILLEDGE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-3806
Mailing Address - Country:US
Mailing Address - Phone:706-548-0008
Mailing Address - Fax:706-369-9673
Practice Address - Street 1:740 PRINCE AVE
Practice Address - Street 2:BUILDING 15
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5908
Practice Address - Country:US
Practice Address - Phone:706-548-0008
Practice Address - Fax:706-369-9673
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2018-02-01
Deactivation Date:2014-08-19
Deactivation Code:
Reactivation Date:2014-09-03
Provider Licenses
StateLicense IDTaxonomies
GARN177223363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner