Provider Demographics
NPI:1811481633
Name:PARKER, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 TUB LN
Mailing Address - Street 2:
Mailing Address - City:SALE CREEK
Mailing Address - State:TN
Mailing Address - Zip Code:37373-3300
Mailing Address - Country:US
Mailing Address - Phone:423-505-6284
Mailing Address - Fax:
Practice Address - Street 1:4589 RHEA COUNTY HWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-6076
Practice Address - Country:US
Practice Address - Phone:423-428-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF02180026363LF0000X
TN23965363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily