Provider Demographics
NPI:1669888665
Name:SAUNDERS, MARIETTA (RNFA)
Entity type:Individual
Prefix:
First Name:MARIETTA
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2471 SIERRA HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-7248
Mailing Address - Country:US
Mailing Address - Phone:770-880-1840
Mailing Address - Fax:
Practice Address - Street 1:2471 SIERRA HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-7248
Practice Address - Country:US
Practice Address - Phone:770-880-1840
Practice Address - Fax:248-850-7424
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN263311163WR0006X, 163W00000X, 163WR0006X
GA4111246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No163W00000XNursing Service ProvidersRegistered Nurse