Provider Demographics
NPI:1730520420
Name:NASH, SARAH A (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:A
Last Name:NASH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4589 LAWRENCEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7320
Mailing Address - Country:US
Mailing Address - Phone:770-466-8672
Mailing Address - Fax:
Practice Address - Street 1:4589 LAWRENCEVILLE RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-7320
Practice Address - Country:US
Practice Address - Phone:770-466-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006790363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant