Provider Demographics
NPI:1811510357
Name:TOLER, SARAH HAMMOCK (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:HAMMOCK
Last Name:TOLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-4770
Mailing Address - Country:US
Mailing Address - Phone:912-538-8484
Mailing Address - Fax:912-538-8665
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-4770
Practice Address - Country:US
Practice Address - Phone:912-538-8484
Practice Address - Fax:912-538-8665
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN254635363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN254635OtherGEORGIA BOARD OF NURSING