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Individual

SARAH N MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN170479
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119107548A
GA
05
119107548B
GA
05
119107548C
GA
Enumeration date
11/20/2009
Last updated
06/20/2012
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