Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN181114 | GA |
NPI | 1003046129 |
---|---|
Provider Name | Mrs. Sara E. Swann |
First Address | Athens, GA 30605-2748 |
Second Address | Danielsville, GA 30633-7058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2009 |
Last Update Date | 14/06/2021 |