Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN244634 | GA |
NPI | 1003445313 |
---|---|
Provider Name | Sarika Mishra |
First Address | Augusta, GA 30903-1705 |
Second Address | Augusta, GA 30901-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2020 |
Last Update Date | 16/10/2020 |