Provider Demographics
NPI:1700178258
Name:BANNISTER, SARAH C (APN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:BANNISTER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:F
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-6328
Mailing Address - Country:US
Mailing Address - Phone:865-588-1718
Mailing Address - Fax:865-338-5897
Practice Address - Street 1:301 CLARK ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-6328
Practice Address - Country:US
Practice Address - Phone:865-588-1718
Practice Address - Fax:865-338-5897
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15789363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN15789OtherADVANCED PRACTICE NURSE
TNQ019285Medicaid